The effect of botulinum toxin type A injection into the gastrocnemius muscle on sit-to-stand transfer in children with spastic diplegic cerebral palsy.
OBJECTIVE
To investigate the benefit of botulinum toxin type A injection into the ankle plantarflexor muscle on sit-to-stand transfer in children with spastic diplegic cerebral palsy.


METHODS
Case-control study.


METHODS
Inpatients in a university-affiliated hospital.


METHODS
Forty spastic diplegic children aged from 2 to 6 years (18 children with botulinum toxin type A injection into both gastrocnemius muscles as an experimental group and 14 children without injection as a control group).


METHODS
Sit-to-stand transfer task was evaluated using a motion analyser (Vicon 370 MA with six infrared cameras). The tests were performed twice with a two- week interval. The changes in temporal, kinematic and kinetic parameters were investigated in each group.


RESULTS
In the control group there were no significant changes in any of the measured parameters between the tests. In the experimental group, total duration (s) of sit-to-stand transfer was shortened after injection (4.35 +/- 2.49 to 2.89 +/- 1.48, P < 0.05). The maximal angles (degrees) of pelvic and hip joints were reduced (28.88 +/- 5.53 to 26.57 +/- 3.73 and 90.78+8.69 to 87.23 +/- 8.76) and the initial angle of ankle dorsiflexion was increased (4.41 +/- 6.16 to 7.08 +/- 6.09) after injection (P < 0.05). The maximal moments (Nm/kg) of the hip and knee joints (0.44 +/- 0.17 to 0.51 +/- 0.21 and 0.13 +/- 0.05 to 0.18 +/- 0.14) were increased while that of the ankle joint was reduced (0.32 +/- 0.09 to 0.28 +/- 0.10) after injection (P < 0.05). Only the cases with greater reduction of spasticity showed an improvement on kinematic and kinetic parameters.


CONCLUSIONS
Botulinum toxin type A injection into spastic ankle plantarflexors led to better accomplishment of sit-to-stand transfer in children with spastic diplegic cerebral palsy.
Park
Eun Sook
ES
Department of Rehabilitation Medicine and Research, Institute of Rehabilitation, Yonsei University College of Medicine, Seoul, Korea pes1234@yumc.yonsei.ac.kr
Park
Chang Il
CI
Chang
Hyun Chung
HC
Park
Chan Woo
CW
Lee
Don Shin
DS
D000842:Ankle; D019274:Botulinum Toxins, Type A / Q000008:administration & dosage*; D016022:Case-Control Studies; D002547:Cerebral Palsy / Q000150:complications*; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007273:Injections, Intramuscular; D009128:Muscle Spasticity / Q000188:drug therapy* / Q000209:etiology; D018482:Muscle, Skeletal / Q000187:drug effects*; D009465:Neuromuscular Agents / Q000008:administration & dosage*
D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A