{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,17]],"date-time":"2025-10-17T14:23:58Z","timestamp":1760711038071,"version":"build-2065373602"},"reference-count":22,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2022,9,25]],"date-time":"2022-09-25T00:00:00Z","timestamp":1664064000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"JSPS KAKENHI","award":["JP19K20018"],"award-info":[{"award-number":["JP19K20018"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Toxins"],"abstract":"<jats:p>(1) Background: The purpose of this retrospective case-control study was to determine the relationship between the control of toe movements by flexor hallucis longus (FHL) and flexor digitorum longus (FDL) muscles and the response to treatment with botulinum toxin (BoNT) in post-stroke patients with claw toe. (2) Methods: Subjects with stroke-related leg paralysis\/spasticity and claw toes received multiple injections of BoNT (onabotulinumtoxin A) into the FHL or FDL muscles. We investigated the relationship between the mode of transmission of FHL and FDL muscle tension to each toe (MCT) and treatment outcome using the data of 53 patients who received 124 injections with clinically recorded treatment outcome. We also dissected the potential variables that could determine the treatment outcome. (3) Results: The effectiveness of BoNT treatment was significantly altered by FDL-MCT (OR = 0.400, 95% CI = 0.162\u20130.987, p = 0.047). Analysis of the response to the first BoNT injection showed an odds ratio of FDL-MCT of approximately 6.0 times (OR = 0.168, 95% CI = 0.033\u20130.857, p = 0.032). The more tibial the influence of the FDL muscle on each toe, the better the treatment outcome on the claw toe. (4) Conclusions: The anatomic relation between FDL muscle and each toe seems to affect the response to treatment with BoNT in post-stroke patients with claw toes.<\/jats:p>","DOI":"10.3390\/toxins14100666","type":"journal-article","created":{"date-parts":[[2022,9,29]],"date-time":"2022-09-29T01:23:16Z","timestamp":1664414596000},"page":"666","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Effects of Flexor Digitorum Longus Muscle Anatomical Structure on the Response to Botulinum Toxin Treatment in Patients with Post-Stroke Claw Foot Deformity"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7077-4261","authenticated-orcid":false,"given":"Toru","family":"Takekawa","sequence":"first","affiliation":[{"name":"Department of Rehabilitation Medicine, The Jikei University School of Medicine, Tokyo 105-8461, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0573-1174","authenticated-orcid":false,"given":"Kazushige","family":"Kobayashi","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine, The Jikei University School of Medicine, Tokyo 105-8461, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Naoki","family":"Yamada","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine, The Jikei University School of Medicine, Tokyo 105-8461, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Satoshi","family":"Takagi","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine, The Jikei University School of Medicine, Tokyo 105-8461, Japan"},{"name":"Shinagawa Rehabilitation Hospital, Tokyo 141-0001, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4153-168X","authenticated-orcid":false,"given":"Takatoshi","family":"Hara","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine, The Jikei University School of Medicine, Tokyo 105-8461, Japan"},{"name":"National Center of Neurology and Psychiatry, Tokyo 187-8551, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tomohide","family":"Kitajima","sequence":"additional","affiliation":[{"name":"Department of Cerebrospinal Surgery, Medical Center Narita Hospital, Narita, Chiba 286-0845, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tomoharu","family":"Sato","sequence":"additional","affiliation":[{"name":"Motoyama Rehabilitation Hospital, Kobe 658-0015, Hyogo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroshi","family":"Sugihara","sequence":"additional","affiliation":[{"name":"Department of Neurology, Kita-Kashiwa Rehabilitation General Hospital, Kashiwa, Chiba 277-0004, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kazuo","family":"Kinoshita","sequence":"additional","affiliation":[{"name":"The Jikei University Hospital, Tokyo 105-8471, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6701-4974","authenticated-orcid":false,"given":"Masahiro","family":"Abo","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine, The Jikei University School of Medicine, Tokyo 105-8461, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,9,25]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"615","DOI":"10.2490\/jjrmc.52.615","article-title":"An Important Consideration when Using Botulinum Toxin Injections for Treating Claw Foot Deformity","volume":"52","author":"Takekawa","year":"2015","journal-title":"Jpn. 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