%0 Journal Article %1 Reddihough2002 %A Reddihough, Dinah S %A King, Jane A %A Coleman, Grahame J %A Fosang, Adrienne %A McCoy, Anne T %A Thomason, Pamela %A Graham, H. Kerr %D 2002 %J Dev Med Child Neurol %K Botulinum Toxin Type A; Cerebral Palsy; Cross-Over Studies; Humans; Lower Extremity; Neuromuscular Agents; Physical Therapy Modalities; Questionnaires; Severity of Illness Index; Treatment Outcome %N 12 %P 820--827 %T Functional outcome of botulinum toxin A injections to the lower limbs in cerebral palsy. %V 44 %X We evaluated gross motor function following botulinum toxin A (BTX-A) injections in the lower limbs of children with spastic cerebral palsy in a randomized clinical trial, using a cross-over design. Forty-nine children (24 males, 25 females, age range 22 to 80 months) were randomly allocated to two groups: group 1 received BTX-A and physiotherapy, and group 2 received physiotherapy alone for 6 months. At the end of this period, group 2 received BTX-A and physiotherapy and group 1 continued with physiotherapy alone. Assessment measures were the Gross Motor Function Measure (GMFM), the Vulpe Assessment Battery (VAB), joint range of movement, the Modified Ashworth Scale, and a parental questionnaire. Sustained gains in gross motor function were found in both groups of children but the only additional benefit found in group 1 was a significant increase in fine motor rating on the VAB. By contrast, parents rated the benefit of treatment highly. It is likely that assessment at 3 and 6 months post injection was too late to demonstrate peak gross motor function response and that changes in GMFM are not sustained over 6 months with a single dose. Further studies should investigate changes over shorter time periods and consider covariables such as BTX-A dosage, number of injection sites, and the role of repeated injections combined with other interventions such as casting.

@article{Reddihough2002, abstract = {We evaluated gross motor function following botulinum toxin A (BTX-A) injections in the lower limbs of children with spastic cerebral palsy in a randomized clinical trial, using a cross-over design. Forty-nine children (24 males, 25 females, age range 22 to 80 months) were randomly allocated to two groups: group 1 received BTX-A and physiotherapy, and group 2 received physiotherapy alone for 6 months. At the end of this period, group 2 received BTX-A and physiotherapy and group 1 continued with physiotherapy alone. Assessment measures were the Gross Motor Function Measure (GMFM), the Vulpe Assessment Battery (VAB), joint range of movement, the Modified Ashworth Scale, and a parental questionnaire. Sustained gains in gross motor function were found in both groups of children but the only additional benefit found in group 1 was a significant increase in fine motor rating on the VAB. By contrast, parents rated the benefit of treatment highly. It is likely that assessment at 3 and 6 months post injection was too late to demonstrate peak gross motor function response and that changes in GMFM are not sustained over 6 months with a single dose. Further studies should investigate changes over shorter time periods and consider covariables such as BTX-A dosage, number of injection sites, and the role of repeated injections combined with other interventions such as casting.}, added-at = {2014-07-19T21:07:46.000+0200}, author = {Reddihough, Dinah S and King, Jane A and Coleman, Grahame J and Fosang, Adrienne and McCoy, Anne T and Thomason, Pamela and Graham, H. Kerr}, biburl = {https://www.bibsonomy.org/bibtex/276c3ca80959afeb54453e678346dff0c/ar0berts}, groups = {public}, interhash = {4454e9cb2fdad3392e9794339cbf0195}, intrahash = {76c3ca80959afeb54453e678346dff0c}, journal = {Dev Med Child Neurol}, keywords = {Botulinum Toxin Type A; Cerebral Palsy; Cross-Over Studies; Humans; Lower Extremity; Neuromuscular Agents; Physical Therapy Modalities; Questionnaires; Severity of Illness Index; Treatment Outcome}, month = Dec, number = 12, pages = {820--827}, pmid = {12455858}, timestamp = {2014-07-19T21:07:46.000+0200}, title = {Functional outcome of botulinum toxin A injections to the lower limbs in cerebral palsy.}, username = {ar0berts}, volume = 44, year = 2002 }