Quantifying the Restoration of a Norm-Like Gait Pattern from Mid-Foot Strike by Botulinum-Toxin-A Treatment in a Patient with Hereditary Spastic Paraplegia

Hereditary spastic paraplegia is characterized by progressive spasticity and muscle weakness, significantly impairing gait. In neuro-musculoskeletal models, gradually increasing hyperreflexia could simulate severity-related gait patterns. This shows a potential application of neuromusculoskeletal models in predicting outcomes of treatments managing spasticity. As a first step, this case-study investigates the efficacy of Botulinum-Toxin-A in improving gait kinematics in a 54-year-old male with HSP and impaired gait. Instrumented gait analysis was conducted before and after treatment using dynamic time warping to compare the participant’s gait to healthy controls. Post-treatment results showed increased segmental angle range of motions and gait speed. The dynamic time warping analysis revealed a 13% restoration towards a healthy gait, indicating that kinematic analyses effectively quantify BoNT-A treatment effects in HSP patients.