There is debate regarding the efficiency of different dilutions of Botulin toxin type A (BTX-A) injections. Some authors believe that highly diluted BTX-A injections achieve greater neuromuscular blockade resulting in higher spasticity reduction. On the other hand, other researchers suggest that there is no difference in spasticity decrease if either high or low volume toxin is being injected. Studies on this subject lack either the design or the power of study was low. Therefore, there is no clear guideline for an optimal botulinum toxin dilution protocol. In an attempt to have a better understanding, a cross over study was designed. The material will be patients with spastic hemiparesis which will be treated with Botulin toxin at different dilutions. Gait analysis will be used for the evaluation of the Botulin toxin injection on gait improvement. To the best of our knowledge such a trial hasn't been performed yet.
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Change of Ankle motion from baseline to 1 month postinjection
Timeframe: Day 1 (baseline) and at 1 month postinjection
Change of modifies Ashworth scale (from 0 to 4, higher grade means worse spasticity) of the ankle from baseline to 1 month postinjection
Timeframe: Day 1 (baseline) and at 1 month postinjection
Change of standing balance from baseline to 1 month postinjection
Timeframe: Day 1 (baseline) and at 1 month postinjection
Change of walking balance from baseline to 1 month postinjection
Timeframe: Day 1 (baseline) and at 1 month postinjection