Effects on Spasticity and Gait using a 5% Phenol Motor Point Block in Patients with Chronic Hemiparesis / The Japanese Journal of Rehabilitation Medicine

ABSTRACT

Objective: The aim of this study was to assess the effects of using a motor point block with 5% phenol on spasticity and gait in patients with chronic hemiparesis. Methods: Participants were 13 patients with chronic hemiparesis after stroke, brain injury or brain tumor. We performed motor point block (MPB) with 5% phenol to the spastic muscles of the lower extremity that caused talipes varus or talipes equinus (i.e. gastrocnemius, soleus, and tibialis posterior). Before and after the MPB, we assessed modified Ashworth scale (MAS), brace wear scale (BWS) and goal attainment scale (GAS). Walking ability was measured using a 30-m walking timed test and 6-minute duration walking test. The step length, foot area during walking and body weight bearing ratio of the paretic side were measured with force plates. Results: We found significant changes in MAS of the plantar flexors (<i>p</i>=0.007), ankle inverters (<i>p</i>=0.006), walking speed (30-m walking time (<i>p</i>=0.046), 6-minute walking test <i>p</i>=0.016), foot area during the stance phase (<i>p</i>=0.006), and body weight bearing ratio of the paretic side (<i>p</i>=0.007)) and BWS (<i>p</i>=0.002). GAS also showed favorable appraisal of MPB by the participants. Conclusion: MPB with 5% phenol can reduce the spasticity and improve gait speed and stability.