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Abstract

The purpose of this retrospective case-control study was to investigate the relationship between flexor hallucis longus (FHL) and flexor digitorum longus (FDL) control of toe movement and response to botulinum toxin (BoNT) treatment after stroke.Identify patients with claws. (2). Patients with leg paralysis/spasticity and toes due to stroke received multiple injections of BoNT (onabotulinum toxin A) into the FHL or FDL muscle. Using data from 53 patients who received 124 injections with clinically documented treatment outcomes, the relationship between modes of transmission of FHL and FDL muscle tone to each toe (MCT) and treatment outcome I checked. We also analyzed potential variables that may determine treatment outcome. (3. Results: The efficacy of BoNT treatment varied significantly with FDL MCT (OR = 0.400, 95% CI = 0.162-0.987, p = 0.047). Analysis of response to the first BoNT injection showed an odds ratio for FDL-MCT of approximately 6.0-fold (OR=0.168, 95% CI=0.033-0.857, p=0.032).The more tibial side of her FDL muscle influence on each toe, the better the nail toe treatment results. The anatomical relationship between the FDL muscle and each toe appears to influence the response of a post-stroke patient with clawed toes to her treatment with BoNT.