{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T16:09:07Z","timestamp":1782403747848,"version":"3.54.5"},"reference-count":47,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2025,1,21]],"date-time":"2025-01-21T00:00:00Z","timestamp":1737417600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Inge-Diesbach Stiftung"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JFMK"],"abstract":"<jats:p>Objective: Botulinum neurotoxin type A (BoNT\/A) injections and the new vibration ergometry training (VET) are studied for their combined effect on improving functional mobility in patients with asymmetric lower limb spasticity. Method: Gait was analyzed using the Infotronic\u00ae system, which measures ground reaction forces and foot contact patterns by means of special force-sensitive shoes strapped over feet or street shoes. Gait was measured several times, depending on the protocol patients underwent. Seven patients with asymmetric lower limb spasticity were analyzed according to the control protocol (CG-group): after a baseline walk of 20 m (NV-W1) patients received their routine BoNT\/A injection and had to walk the same distance a second time (NV-W2). Approximately 3\u20135 weeks later, they had to walk a third time (NV-W3). A further seven patients (VG-group) were analyzed according to the vibration protocol: after a baseline walk (V-W1), patients underwent a first vibration training (VET1), walked a second time (V-W2), received their routine BoNT\/A injection, and walked a third time (V-W3). About four weeks later, they had to walk again (V-W4), received another vibration training (VET3), and walked a fifth time (V-W5). At least six months after the analysis according to the vibration protocol, these patients were also analyzed according to the control protocol. Eleven gait parameters were compared between the CG- and VG-group, and within the VG-group. Result: Patients in the VG-group experienced a significant improvement in gait four weeks after BoNT\/A injection, unlike the patients in the CG-group. VG-patients also showed improved gait after two VET sessions. However, there was no further functional improvement of gait when BoNT\/A injections and VET sessions were combined. Conclusions: BoNT\/A injections enhance functional mobility in patients with mild asymmetric leg spasticity. VET also induces an immediate gait improvement and offers a further treatment approach for leg spasticity. Whether combining BoNT treatment and vibration training offers superior outcomes compared to either treatment alone requires further investigation.<\/jats:p>","DOI":"10.3390\/jfmk10010041","type":"journal-article","created":{"date-parts":[[2025,1,21]],"date-time":"2025-01-21T05:47:42Z","timestamp":1737438462000},"page":"41","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Effects of Combined Vibration Ergometry and Botulinum Toxin on Gait Improvement in Asymmetric Lower Limb Spasticity: A Pilot Study"],"prefix":"10.3390","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1069-7684","authenticated-orcid":false,"given":"Harald","family":"Hefter","sequence":"first","affiliation":[{"name":"Department of Neurology, University of D\u00fcsseldorf, Moorenstrasse 5, 40225 D\u00fcsseldorf, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dietmar","family":"Rosenthal","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of D\u00fcsseldorf, Moorenstrasse 5, 40225 D\u00fcsseldorf, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3593-1852","authenticated-orcid":false,"given":"Sara","family":"Samadzadeh","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of D\u00fcsseldorf, Moorenstrasse 5, 40225 D\u00fcsseldorf, Germany"},{"name":"Charit\u00e9\u2013Universit\u00e4tsmedizin Berlin, Corporate Member of Freie Universit\u00e4t Berlin and Humboldt-Unverst\u00e4t zu Berlin, Experimental and Clinical Research Center, 13125 Berlin, Germany"},{"name":"Department of Regional Health Research and Molecular Medicine, University of Southern Denmark, 5230 Odense, Denmark"},{"name":"Department of Neurology, Slagelse Hospital, 4200 Slagelse, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,1,21]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"400","DOI":"10.3109\/00016489309135834","article-title":"Botulinum A toxin effects on rat jaw muscle spindles","volume":"113","author":"Filippi","year":"1993","journal-title":"Acta Otolaryngol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"488","DOI":"10.1002\/(SICI)1097-4598(199604)19:4<488::AID-MUS9>3.0.CO;2-8","article-title":"Extrafusal and intrafusal effects in experimental botulinum toxin-A injection","volume":"19","author":"Rosales","year":"1996","journal-title":"Muscle Nerve Off. 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