title: Botulinum Toxin Treatment on Upper Limb Function in School Age Children With Bilateral Spastic Cerebral Palsy: One Year Follow-up.
abstract: OBJECTIVE
  To prospectively investigate the long-term effects of botulinum toxin treatment on the upper limb function and performance of school age children with spastic bilateral cerebral palsy, who have limitations in performing activities of daily living and school activities, due to spasticity of the upper extremities.
  
  
  METHODS
  Botulinum type A toxin (BoNT-A) was injected into 24 spastic upper limbs of 15 children. We used a Modified Ashworth Scale and a Modified Tardieu Scale for the evaluation of upper limb spasticity, and Quality of Upper Extremity Skills Test (QUEST), Canadian Occupational Performance Measure (COPM), and Test of Visual-Motor Skills-Revised (TVMS-R) for the evaluation of upper limb function and performance.
  
  
  RESULTS
  Upper limb spasticity continuously decreased until the end of the one-year follow-up. Upper limb function on QUEST and COPM showed the best performance at 3 months and deteriorated slightly, but still showed a significantly better performance at 9 and 12 months than at pre-injection. In more functional nine subjects who could perform TVMS-R, the performance enhancement effects remained constant after 12 months, suggesting that the reduced spasticity led to the learning effect acquired by the repeated use of the affected upper limb.
  
  
  CONCLUSIONS
  For school age children with bilateral spastic cerebral palsy whose upper limb functions are important, BoNT-A injections seem to be of help in the performance of school activities and activities of daily living.
authors.affiliation: Department of Rehabilitation Medicine, Seoul Rehabilitation Hospital, Seoul, Korea.
authors.forename: Jee Sun
authors.initials: JS
authors.lastname: Lee
authors.forename: Kyu Bum
authors.initials: KB
authors.lastname: Lee
authors.forename: Yu Ryun
authors.initials: YR
authors.lastname: Lee
authors.forename: You Nam
authors.initials: YN
authors.lastname: Choi
authors.forename: Chul Woo
authors.initials: CW
authors.lastname: Park
authors.forename: Sang Duck
authors.initials: SD
authors.lastname: Park
authors.forename: Dong Hwa
authors.initials: DH
authors.lastname: Jung
authors.forename: Chul Sang
authors.initials: CS
authors.lastname: Lee
keywords: Botulinum A toxin; Cerebral palsy; School; Upper limb