Short-term effects of combined serial casting and botulinum toxin injection for spastic equinus in ambulatory children with cerebral palsy.
OBJECTIVE
The purpose of this paper is to test the hypothesis that combination therapy of serial cast and botulinum toxin type A (BTX-A) injection can further enhance the effects of a BTX-A injection in ambulant children with cerebral palsy (CP) who have an equinus foot.


METHODS
Children in group A (30 legs of 21 children) received a serial casting application after an injection of BTX-A, and children in group B (25 legs of 17 children) received only a BTX-A injection. Assessments were performed before the intervention and 1 month after the intervention.


RESULTS
After the intervention, there were significant improvements in tone, dynamic spasticity, and passive range of motion (ROM) in both groups. However, the changes were greater in group A than in group B. Dimension D (standing) in Gross Motor Function Measure (GMFM)-66 was significantly improved in group A but not in group B. On the other hand, there were no significant changes in dimension E (walking, running, jumping) in GMFM-66 in either group.


CONCLUSIONS
The results of our study suggest that a serial casting application after BTX-A injection can enhance the benefits of BTX-A injection in children with cerebral palsy.
Park
Eun Sook
ES
Department and Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea.
Rha
Dong-Wook
DW
Yoo
Jun Ki
JK
Kim
Sun Mi
SM
Chang
Won Hyuk
WH
Song
Sang Hyuk
SH
D019274:Botulinum Toxins, Type A / Q000627:therapeutic use*; D002370:Casts, Surgical; D002547:Cerebral Palsy / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D004863:Equinus Deformity / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D009465:Neuromuscular Agents / Q000627:therapeutic use*; D016059:Range of Motion, Articular
D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A