title: The effect of botulinum toxin type-A injection on spasticity, range of motion and gait patterns in children with spastic diplegic cerebral palsy: an Egyptian study.
abstract: Spasticity is defined as increased resistance to passive movement, secondary to hyperreflexia after an upper motor neuron lesion. In children with cerebral palsy (CP), it can interfere with mobility and self-care and can contribute to development of fixed myostatic contractures. This study investigated the efficacy of botulinum toxin type-A, a neuromuscular blocking agent that reduces muscle tone, in a variety of neuromuscular disorders, injections in a prospective, 3-month, controlled study involving 40 children with spastic diplegic CP. The patients were divided into two groups: Group 1 (20 patients) entered a botulinum toxin type-A injection+physiotherapy rehabilitation program; Group 2 (20 patients) were given the physiotherapy rehabilitation program only. Patients were assessed at 4, 8 and 12 weeks post-treatment using the Modified Ashworth Scale (MAS), dynamic gait pattern, ankle range-of-motion measurements and quantification of muscle denervation by nerve conduction techniques. The botulinum toxin type-A group demonstrated statistically significantly decreased spasticity, improved gait function and improved range of motion with evidence of partial denervation of the injected muscle compared to the control group. In conclusion, botulinum toxin type-A injections are a well-tolerated, non-surgical technique that can improve overall response to physiotherapy.
authors.affiliation: Department of Neurology, Faculty of Medicine, Ain Shams University, Cairo, Egypt. etribima@hotmail.com
authors.forename: M A
authors.initials: MA
authors.lastname: El-Etribi
authors.forename: M E
authors.initials: ME
authors.lastname: Salem
authors.forename: H M
authors.initials: HM
authors.lastname: El-Shakankiry
authors.forename: A M
authors.initials: AM
authors.lastname: El-Kahky
authors.forename: S M
authors.initials: SM
authors.lastname: El-Mahboub
mesh_terms: D000843:Ankle Joint / Q000503:physiopathology; D019274:Botulinum Toxins, Type A / Q000494:pharmacology*; D002547:Cerebral Palsy / Q000503:physiopathology* / Q000534:rehabilitation*; D002648:Child; D002675:Child, Preschool; D004534:Egypt; D005260:Female; D005684:Gait / Q000187:drug effects*; D006801:Humans; D008297:Male; D009465:Neuromuscular Agents / Q000494:pharmacology*; D011594:Psychometrics; D016059:Range of Motion, Articular
chemical_list: D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A