Effect of multisite botulinum toxin injections on gait quality in adults with cerebral palsy.
OBJECTIVE
In the management of adults with cerebral palsy (CP), one of the goals is to monitor and prevent spasticity-related deteriorations in gait. Botulinum Toxin Injections (BTI) are commonly used to treat this spasticity in these patients. The purpose of this study was to evaluate (i) the effect of multi-site BTI on gait patterns in adults with CP and (ii) to determine if these modifications could be detected by the Gait Deviation Index (GDI).


METHODS
Spontaneous-velocity gait was recorded using 3D gait analysis before and 1 month after multi-site BTI in lower limb muscles. Spatiotemporal parameters (STP), kinematic parameters (KP) and the GDI were computed.


RESULTS
Post BTI, stride length, peak hip flexion and peak knee flexion during Swing Phase (SW) were significantly increased while the GDI was not significantly modified.


CONCLUSIONS
A single multi-site BTI improved STP and KP of adults with CP but the GDI was not sensitive enough to detect these changes. Implications for Rehabilitation Only few study on adults with cerebral palsy BTI approach on the gait patterns are largely unknown. BTI session induced only some smaller improvement of KP and STP. This improvement did not modify the GDI. We cannot determine if GDI is a relevant tool to evaluate changes following BTI or other types of treatment.
Movement Analysis Laboratory , CHU Raymond Poincaré, Garches , France and.
Claire
C
Marchiori
Nicolas
N
Roche
Nicolas
N
Vuillerme
Raphael
R
Zory
Didier
D
Pradon
D000293:Adolescent; D000328:Adult; D019274:Botulinum Toxins, Type A / Q000008:administration & dosage*; D016022:Case-Control Studies; D002547:Cerebral Palsy / Q000175:diagnosis / Q000188:drug therapy* / Q000534:rehabilitation; D015331:Cohort Studies; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D005684:Gait / Q000187:drug effects* / Q000502:physiology; D006801:Humans; D007273:Injections, Intramuscular; D035002:Lower Extremity; D008297:Male; D008875:Middle Aged; D009126:Muscle Relaxation / Q000187:drug effects; D018482:Muscle, Skeletal / Q000187:drug effects*; D058996:Quality Improvement; D012016:Reference Values; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric; D016896:Treatment Outcome; D055815:Young Adult
D019274:Botulinum Toxins, Type A
Adult; Gait Deviation index; cerebral palsy; spasticity; type A botulinum toxin