[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"health-studies-list:{\"conditionNormalized\":\"spasticity-of-the-plantar-flexors\",\"overallStatus\":[\"RECRUITING\",\"AVAILABLE\",\"NOT_YET_RECRUITING\"],\"orderBy\":\"LastUpdateSubmitDate:desc\",\"size\":25,\"offset\":0}":3,"health-study-condition:spasticity-of-the-plantar-flexors":30},{"pageToken":4,"total":5,"offset":6,"count":5,"results":7},null,2,0,[8,45],{"id":9,"slug":10,"hasResults":11,"nctId":12,"briefTitle":13,"officialTitle":14,"acronym":4,"eligibilityCriteria":15,"healthyVolunteers":11,"sex":16,"minAge":17,"maxAge":18,"enrollmentInfo":19,"targetDuration":4,"studyType":22,"phases":23,"briefSummary":25,"conditions":26,"keywords":4,"overallStatus":32,"whyStopped":4,"lastUpdateSubmitDate":33,"lastUpdatePostDateStruct":34,"startDateStruct":37,"completionDateStruct":39,"leadSponsor":41,"locationsCount":44},"100646228","extracorporeal-shock-wave-therapy-in-botulinum-toxin-treated-patients-with-post-stroke-ankle-plantar-flexor-spasticity-100646228",false,"NCT07695038","Extracorporeal Shock Wave Therapy in Botulinum Toxin-Treated Patients With Post-Stroke Ankle Plantar Flexor Spasticity","Effectiveness of Extracorporeal Shock Wave Therapy as an Adjunct to Botulinum Toxin Injection in Patients With Post-Stroke Ankle Plantar Flexor Spasticity: A Randomized Controlled Trial","Inclusion Criteria:\n\n* Diagnosis of stroke according to the World Health Organization (WHO) (1989) definition.\n* Stroke diagnosis confirmed by magnetic resonance imaging (MRI).\n* Patients aged between 18 and 65 years.\n* Clinically stable condition after stroke.\n* Patients who have undergone routine Botulinum Toxin Type A (BoNT-A) injection to the gastrocnemius muscle.\n* Presence of ankle plantar flexor spasticity with a Modified Ashworth Scale (MAS) score of greater than or equal to 1 (MAS ≥ 1).\n\nExclusion Criteria:\n\n* Presence of fixed contracture at the ankle joint.\n* History of prior antispastic surgical procedures.\n* Changes in antispastic medication dosage or type within the last 6 months.\n* Active infection or malignancy at the application site.\n* Presence of a cardiac pacemaker.\n* Bleeding disorders or advanced vascular disease.\n* Pregnancy.\n* Presence of neuromuscular junction disease or motor neuron disease.\n* Known allergy or hypersensitivity to Botulinum Toxin Type A.\n* Current use of antibiotics.","ALL","18 Years","65 Years",{"count":20,"type":21},32,"ESTIMATED","INTERVENTIONAL",[24],"NA","The goal of this clinical trial is to learn if radial Extracorporeal Shock Wave Therapy (rESWT) is effective in reducing ankle plantar flexor spasticity and improving walking functions in stroke patients who have already received Botulinum Toxin type A (BoNT-A) injections. The main questions it aims to answer are:\n\n* Does adding rESWT to standard physical therapy significantly lower muscle spasticity in patients who have received BoNT-A, compared to receiving physical therapy alone after the injection?\n* Does combining rESWT with BoNT-A injection improve functional walking parameters (such as gait speed, cadence, and step length) and daily life independence more than the BoNT-A and physical therapy combination alone?\n* Can rESWT induce additional structural and flexibility improvements in the BoNT-A injected gastrocnemius muscle, as measured objectively by ultrasound imaging and strain elastography?\n\nResearchers will compare a group of participants receiving both rESWT and conventional physical therapy (Group 1) to a comparison group receiving only conventional physical therapy (Group 2) to see if rESWT provides additional clinical benefits. All participants in both groups will have already undergone routine BoNT-A injections one week prior to starting the study treatments.\n\nParticipants will:\n\n* Undergo a 3-week conventional physical therapy and rehabilitation program, consisting of 2 to 3 hours of therapy per day, 5 days a week.\n* Receive 3 weekly sessions of rESWT (2000 pulses per session applied to the calf muscles) if they are randomized into the rESWT group.\n* Attend clinical evaluation visits and objective assessment sessions-including high-tech computerized gait analysis and specialized musculoskeletal ultrasound imaging-before the treatment, at the end of the 3rd week, and at a 12-week follow-up.",[27,28,29,30,31],"Stroke","Post-stroke Spasticity of the Lower Limb","Post-Stroke Spasticity","Spasticity of the Plantar Flexors","Spasticity, Post-Stroke","NOT_YET_RECRUITING","2026-07-04",{"date":35,"type":36},"2026-07-10","ACTUAL",{"date":38,"type":21},"2026-07-20",{"date":40,"type":21},"2027-08-20",{"name":42,"class":43},"Pamukkale University","OTHER",1,{"id":46,"slug":47,"hasResults":11,"nctId":48,"briefTitle":49,"officialTitle":49,"acronym":50,"eligibilityCriteria":51,"healthyVolunteers":11,"sex":16,"minAge":17,"maxAge":4,"enrollmentInfo":52,"targetDuration":4,"studyType":22,"phases":54,"briefSummary":55,"conditions":56,"keywords":4,"overallStatus":32,"whyStopped":4,"lastUpdateSubmitDate":57,"lastUpdatePostDateStruct":58,"startDateStruct":60,"completionDateStruct":62,"leadSponsor":64,"locationsCount":4},"100612975","impact-of-a-sequential-isokinetic-fatigue-protocol-followed-by-ankle-strengthening-after-botulinum-toxin-injection-into-spastic-plantar-flexors-on-foot-lift-strength-and-walking-100612975","NCT07260565","Impact of a Sequential Isokinetic Fatigue Protocol Followed by Ankle Strengthening After Botulinum Toxin Injection Into Spastic Plantar Flexors on Foot Lift Strength and Walking","ISOTOX","Inclusion Criteria:\n\n* Adult patient\n* Patient with spastic hemiplegia (regardless of cause)\n* MAS 1-2 spasticity of the plantar flexors\n* Deficit of the foot lifters at the minimum stage of contraction with movement\n* Patient who has received botulinum toxin injections in the plantar flexors\n* Patient who has been informed about the research and has given their written and signed informed consent\n* Patient affiliated with a social security scheme or beneficiary of such a scheme\n\nExclusion Criteria:\n\n* Refusal of consent\n* Patient with severe cognitive impairment (MMSE \\\u003C23\u002F30)\n* Surgery on the affected lower limb\n* Patient unable to read, write or understand French\n* Patient who is pregnant or breastfeeding, in accordance with Article L1121-5 of the CSP\n* Vulnerable patients according to Article L1121-6 of the CSP\n* Adult patients under guardianship, curatorship or judicial protection\n* Patients unable to give their consent in person according to Article L.1121-8 of the CSP or adults protected by law",{"count":53,"type":21},30,[24],"Spastic foot drop (speed- and force-dependent hypertonia) is one of the most common neuro-orthopaedic disorders following brain injury. It has a negative impact on walking and is closely linked to independence in activities of daily living.\n\nThis disorder combines a deficit in muscle strength in the plantar flexors and extensors with pathological hypertonia of the plantar flexors, causing an imbalance in ankle flexion and resulting in equinus deformity of the foot.\n\nBotulinum toxin is the first-line pharmacological treatment for focal spasticity of neurological origin, and its effectiveness is directly linked to the quality and quantity of associated rehabilitation care. However, the associated rehabilitation protocols remain vague and are based on general recommendations combining: stretching of muscles and tendons, muscle strengthening of spastic muscles, their agonists and antagonists, and functional work. The standard rehabilitation protocol used in our centre will be detailed in the study protocol.\n\nThe isokinetic dynamometer is an open-chain muscle strengthening tool that has the advantage of introducing a concept of reproducible assessment and rehabilitation.\n\nThis reproducibility is difficult to guarantee with the rehabilitation techniques practised by a therapist, whose applied force and precision may vary from one session to another. We have therefore developed a sequential muscle strengthening protocol combining strengthening work - fatigue of the triceps surae followed by muscle strengthening work of the foot lifters.\n\nThe aim of this work is to determine the effects of this protocol compared to conventional rehabilitation aimed at promoting the post-injection effects of botulinum toxin.",[30],"2025-12-16",{"date":59,"type":36},"2025-12-17",{"date":61,"type":21},"2026-01-01",{"date":63,"type":21},"2028-11-01",{"name":65,"class":43},"Clinique Victor Pauchet"]