Ultrasound-guided botulinum toxin type A injection to the iliopsoas muscle in the management of children with cerebral palsy.
OBJECTIVE
To determine the effect of botulinum toxin type A (BTX-A) on spasticity and functional development in children with cerebral palsy (CP) in conjunction with a physiotherapy program.


METHODS
In this prospective study, 18 CP patients were evaluated. Multilevel BTX-A injection was applied to children at a dose of 15 U/kg. Children were assessed before and at the 5th and 12th week post-injection using Thomas test, Duncan-Ely test, passive range of motion (pROM) measurement, Distance Between Knee (DBK), Selective Motor Control (SMC) scale, modified Ashworth Scale (MAS) and modified Physician Rating Scale (mPRS). To assess functional improvement, Gross Motor Function Measure (GMFM) and Functional Independence Measure for Children (WeeFIM) were used before and at the 12th week post-injection.


RESULTS
At 5th week post-injection, a statistically significant decrease was determined in spasticity (p < 0.01). Improvement was observed in mPRS and pROM, but not in SMC. At the 12th week post-injection, GMFM (p< 0.001) and WeeFIM improved significantly (p< 0.001). The improvement in pROM and mPRS (p< 0.01) lasted until the 12th week post-injection, but the improvement in MAS (p > 0.05) and in the Tardieu test of hip adductors (p > 0.05) did not last after the 5th week.


CONCLUSIONS
BTX-A injection enhances functional and motor abilities in the development process.
Ministry of Health Diskapi Research and Education Hospital, Clinic of Physical Medicine and Rehabilitation, Ankara, Turkey. drrahime@hotmail.com
R
R
Depedibi
E
E
Unlü
A
A
Cevikol
T
T
Akkaya
A
A
Cakci
R
R
Cerekçi
G
G
Köse
D
D
Unlüsoy
D000203:Activities of Daily Living; D019274:Botulinum Toxins, Type A / Q000627:therapeutic use*; D002547:Cerebral Palsy / Q000000981:diagnostic imaging / Q000534:rehabilitation*; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007273:Injections, Intramuscular; D008297:Male; D009460:Neurologic Examination; D026741:Physical Therapy Modalities; D016658:Psoas Muscles / Q000000981:diagnostic imaging / Q000187:drug effects*; D016059:Range of Motion, Articular / Q000187:drug effects; D014421:Turkey; D014463:Ultrasonography
D019274:Botulinum Toxins, Type A