title: Botulinum toxin-A with and without rehabilitation for the treatment of spastic cerebral palsy.
abstract: OBJECTIVE
  To determine the efficacy of botulinum toxin-A (BTX-A) nerve block, with and without rehabilitation, in the treatment of spastic cerebral palsy.
  
  
  METHODS
  Patients (aged 1-23 years) with spastic cerebral palsy underwent nerve block with BTX-A, followed by ≥ 2 h/day rehabilitation (experimental group) or <2 h/day rehabilitation (control group). Muscle tension and motor function were evaluated pre-block using the Modified Ashworth Scale (MAS) and gross motor function measure (GMFM), respectively. MAS was assessed weekly to determine duration of action of BTX-A; GMFM was assessed at 1 year post-block.
  
  
  RESULTS
  There were no significant differences between the experimental group (n = 120) and the control group (n = 124) in age, body weight, pre-block MAS or GMFM, or BTX-A duration of action. MAS was significantly improved in both groups at 1 month post-block. At 1 year post-block, GMFM was significantly improved in both groups, with a significantly greater improvement seen in the experimental group compared with the control group.
  
  
  CONCLUSIONS
  BTX-A block improved muscle tension and motor function. Rehabilitation training, following the block, resulted in greater improvements to motor function than block alone.
authors.affiliation: Capital Medical University School of Rehabilitation Medicine, China Rehabilitation Research Centre, Beijing, China. ljj990@163.com
authors.forename: Liu
authors.initials: L
authors.lastname: Jianjun
authors.forename: Ji
authors.initials: J
authors.lastname: Shurong
authors.forename: Wu
authors.initials: W
authors.lastname: Weihong
authors.forename: Zhang
authors.initials: Z
authors.lastname: Yan
authors.forename: Zeng
authors.initials: Z
authors.lastname: Fanyong
authors.forename: Li
authors.initials: L
authors.lastname: Nanling
mesh_terms: D000293:Adolescent; D019274:Botulinum Toxins, Type A / Q000627:therapeutic use*; D002547:Cerebral Palsy / Q000503:physiopathology / Q000534:rehabilitation / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009043:Motor Activity / Q000187:drug effects; D009128:Muscle Spasticity / Q000503:physiopathology / Q000534:rehabilitation / Q000628:therapy*; D009129:Muscle Tonus / Q000187:drug effects; D009465:Neuromuscular Agents / Q000627:therapeutic use*; D019148:Neuromuscular Blockade / Q000379:methods*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A
keywords: Botulinum toxin-A; cerebral palsy; long-term effect; nerve block; spasticity