{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T00:58:13Z","timestamp":1777942693811,"version":"3.51.4"},"reference-count":35,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2011,12,9]],"date-time":"2011-12-09T00:00:00Z","timestamp":1323388800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Neurorehabil Neural Repair"],"published-print":{"date-parts":[[2012,6]]},"abstract":"<jats:p>Background. An understanding of the mechanical effects of botulinum toxin type A (BoNT A) on spastic and voluntary muscle contraction may help predict functional responders. Objective. To compare the effect of BoNT A on the voluntary and stretch reflex\u2013related torques produced by activation of the rectus femoris (RF). Methods. This was a prospective open study where 15 incomplete spinal cord injury patients, impaired by a stiff-knee gait, with RF hyperactivity in mid-swing quantified by formal gait analysis (GA), were assessed before and after RF BoNT A injection (Botox, 200 UI). Main outcome measures included isokinetic peak torque (and angle at peak torque) at 0\u00b0 (supine) and 90\u00b0 (seated) during passive stretch (10 deg\/s, 90 deg\/s, and 150 deg\/s), and voluntary contraction (60 deg\/s) of the quadriceps. Secondary measures included impairment by Modified Tardieu Scale (MTS), peak knee flexion and spatial-temporal data by GA, activity (6-minute walking test, timed stair climbing), and discomfort (Verbal Rating Scale). Results. Voluntary torque decreased (\u221216%; P = .0004) but with only a trend toward a decrease in stretch reflex\u2013related torque. The angle at spastic torque increased at 90 deg\/s (+5\u00b0; P = .03), whereas MTS, peak knee flexion (+4\u00b0; P = .01), spatial-temporal data, timed stair climbing test (25%; P = .02), and discomfort were significantly improved. Conclusion. BoNT A appeared to delay the stretch-reflex angle at peak torque, whereas the voluntary torque decreased. After strict patient selection, BoNT A injection into the RF muscle led to improvements in impairment, activity, and discomfort.<\/jats:p>","DOI":"10.1177\/1545968311423668","type":"journal-article","created":{"date-parts":[[2011,12,9]],"date-time":"2011-12-09T23:44:59Z","timestamp":1323474299000},"page":"542-547","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":19,"title":["Botulinum Toxin Effect on Voluntary and Stretch Reflex\u2013Related Torque Produced by the Quadriceps"],"prefix":"10.1177","volume":"26","author":[{"given":"Benjamin","family":"Bernuz","sequence":"first","affiliation":[{"name":"Versailles University, Garches, France"},{"name":"H\u00f4pital Leon Berard, Hy\u00e8res, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fran\u00e7ois","family":"Genet","sequence":"additional","affiliation":[{"name":"Versailles University, Garches, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Philippe","family":"Terrat","sequence":"additional","affiliation":[{"name":"Versailles University, Garches, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Didier","family":"Pradon","sequence":"additional","affiliation":[{"name":"Versailles University, Garches, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Frederic","family":"Barbot","sequence":"additional","affiliation":[{"name":"Versailles University, Garches, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bernard","family":"Bussel","sequence":"additional","affiliation":[{"name":"Versailles University, Garches, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Djamel","family":"Bensmail","sequence":"additional","affiliation":[{"name":"Versailles University, Garches, France"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2011,12,9]]},"reference":[{"key":"bibr1-1545968311423668","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.30.12.1303"},{"key":"bibr2-1545968311423668","doi-asserted-by":"publisher","DOI":"10.1177\/1545968309343213"},{"key":"bibr3-1545968311423668","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa011892"},{"key":"bibr4-1545968311423668","doi-asserted-by":"publisher","DOI":"10.1007\/s00702-007-0869-3"},{"key":"bibr5-1545968311423668","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD003469.pub4"},{"key":"bibr6-1545968311423668","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.69.2.217"},{"key":"bibr7-1545968311423668","doi-asserted-by":"publisher","DOI":"10.1177\/1545968309347683"},{"key":"bibr8-1545968311423668","doi-asserted-by":"publisher","DOI":"10.1177\/1545968309347682"},{"key":"bibr9-1545968311423668","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-1331.2008.02076.x"},{"key":"bibr10-1545968311423668","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-4598(199812)21:12<1701::AID-MUS12>3.0.CO;2-K"},{"key":"bibr11-1545968311423668","first-page":"249","volume":"53","author":"Rosentswieg J","year":"1972","journal-title":"Arch Phys Med Rehabil"},{"key":"bibr12-1545968311423668","first-page":"18","volume-title":"Isocin\u00e9tisme et rachis","volume":"2001","author":"Calmels P"},{"key":"bibr13-1545968311423668","doi-asserted-by":"publisher","DOI":"10.1038\/sj.sc.3100849"},{"key":"bibr14-1545968311423668","doi-asserted-by":"publisher","DOI":"10.1038\/sj.sc.3101282"},{"key":"bibr15-1545968311423668","doi-asserted-by":"publisher","DOI":"10.1016\/j.apmr.2005.03.015"},{"key":"bibr16-1545968311423668","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinbiomech.2005.04.002"},{"key":"bibr17-1545968311423668","doi-asserted-by":"publisher","DOI":"10.1097\/00002060-199112000-00003"},{"key":"bibr18-1545968311423668","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbiomech.2003.12.005"},{"key":"bibr19-1545968311423668","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.108.516153"},{"key":"bibr20-1545968311423668","doi-asserted-by":"publisher","DOI":"10.1016\/j.gaitpost.2008.07.005"},{"key":"bibr21-1545968311423668","doi-asserted-by":"publisher","DOI":"10.1177\/1545968309354535"},{"key":"bibr22-1545968311423668","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-8749.2003.tb00886.x"},{"key":"bibr23-1545968311423668","doi-asserted-by":"publisher","DOI":"10.1016\/j.apmr.2009.11.017"},{"key":"bibr24-1545968311423668","doi-asserted-by":"publisher","DOI":"10.1191\/0269215506cr922oa"},{"key":"bibr25-1545968311423668","volume-title":"Les appareils d\u2019isocin\u00e9tisme en \u00e9valuation et en r\u00e9\u00e9ducation musculaire: int\u00e9r\u00eat et utilisation","year":"2001"},{"key":"bibr26-1545968311423668","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.292.6521.653"},{"key":"bibr27-1545968311423668","unstructured":"Wade DT. 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