Long lasting benefits following the combination of static night upper extremity splinting with botulinum toxin A injections in cerebral palsy children.
OBJECTIVE
Botulinum toxin A injections and orthotics have been used to manage upper extremity spasticity in hemiplegic children. The authors performed a study to evaluate the necessity and effectiveness of a static night splint following outpatient botulinum toxin A treatment in children with upper limb spastic cerebral palsy.


METHODS
Twenty children with upper limb spastic cerebral palsy were treated with botulinum toxin A injections. A static night splint was applied in half of them. Objective assessment of upper limb function was performed at baseline, at 2 and 6 months after botulinum toxin A injection using the Quality of Upper Extremity Skills Test.


RESULTS
After botulinum toxin A treatment, both groups showed an improvement on their previous functional level of the injected upper extremity. At 2 months, children in group A showed a 15.4% improvement, whereas children in group B improved by 12.2% from baseline; these were not statistically significant (P=0.326). At 6 months, group A still maintained a 15.9% improvement in function compared to group B which differed only by 4.2% from prebotulinum toxin A baseline; these differences were statistically significant (P=0.000). Complications related to the botulinum toxin A injection were not observed. The static


CONCLUSIONS
Static night splinting following botulinum toxin A injections has shown a definite treatment effect in reducing spasticity and improving function in children with upper limb spastic cerebral palsy.
Kanellopoulos
A D
AD
First Department of Orthopedics, Athens University Medical School, Athens, Greece.
Mavrogenis
A F
AF
Mitsiokapa
E A
EA
Panagopoulos
D
D
Skouteli
H
H
Vrettos
S G
SG
Tzanos
G
G
Papagelopoulos
P J
PJ
D019274:Botulinum Toxins, Type A / Q000627:therapeutic use*; D002547:Cerebral Palsy / Q000150:complications* / Q000503:physiopathology / Q000628:therapy; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009128:Muscle Spasticity / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D009465:Neuromuscular Agents / Q000627:therapeutic use*; D011446:Prospective Studies; D020127:Recovery of Function; D013165:Splints; D013997:Time Factors; D016896:Treatment Outcome; D034941:Upper Extremity
D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A