Effects of botulinum toxin A therapy with electrical stimulation on spastic calf muscles in children with cerebral palsy.
OBJECTIVE
To assess the additive effect of adjuvant electrical stimulation on botulinum toxin A injection in children with spastic diplegic cerebral palsy.


METHODS
Eighteen children with dynamic foot equinus deformity were treated with botulinum toxin A injection into the calf muscles. Seven children were assigned to a treatment group who received botulinum toxin A and adjuvant electrical stimulation, and 11 children were assigned to a control group with botulinum toxin injection only. Before botulinum injection, and at 2 wks and 3 mos after injection, the Physician Rating Scale, passive ranges of ankle and knee motion, and the modified Ashworth scale were measured.


RESULTS
A significant increase in passive range of ankle motion was observed at 2 wks after injection in the treatment group and at 3 mos after injection in both groups. Both groups showed significant improvements by the modified Ashworth scale at 2 wks after injection. Subscales of the Physician Rating Scale (equinus foot, crouched gait) and total Physician Rating Scale scores were significantly improved in the treatment group at 3 mos after injection, but this was not observed in the control group.


CONCLUSIONS
Adjuvant electrical stimulation for a short period after botulinum toxin A injection was found to benefit early improvement of range of motion and maintenance of gait improvement in children with spastic diplegia cerebral palsy showing dynamic equinus.
Kang
Bo-Sung
BS
Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul, Korea.
Bang
Moon Suk
MS
Jung
Se Hee
SH
D019274:Botulinum Toxins, Type A / Q000008:administration & dosage / Q000627:therapeutic use*; D002547:Cerebral Palsy / Q000534:rehabilitation*; D002648:Child; D002675:Child, Preschool; D004599:Electric Stimulation Therapy; D005260:Female; D005684:Gait; D006801:Humans; D007223:Infant; D007273:Injections, Intramuscular; D008297:Male; D018482:Muscle, Skeletal; D009465:Neuromuscular Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D016059:Range of Motion, Articular; D016896:Treatment Outcome
D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A