title: [Development of motor functions and manual abilities in pediatric patients with spastic cerebral palsy after botulinum toxin treatment and complex rehabilitation].
abstract: OBJECTIVE
  To investigate the dynamic of general motor function and manual abilities in children with spastic forms of cerebral palsy (CP) after complex rehabilitation combined with single and repeated injections of botulinum toxin A (BTA).
  
  
  METHODS
  The article presents 18 month followup of 52 patients with mono- and bilateral spastic forms of CP after single and multiple injections of botulinum toxin A and complex rehabilitation/ Patients received totally 74 injection sessions: 17 (32.7%) children--twice, 5 (9.6%) children--three times. Motor development assessment was done according to the GMFCS and GMFMS-88 scales and centile curves of normal motor development connected with these scales, hand function was classified according to the MACS scale. For the first time results of botulinum toxin therapy and rehabilitation were compared with the natural motor development of patients with different levels of motor disturbances according to centile tables.
  
  
  RESULTS
  Patients with bilateral cerebral palsy improved slowly than hemiparetic and changes lasted for longer period. Level according to the MACS scale didn't depend on the gestational age of the patients, was higher in children with hemiparesis and changed for 1 level in 4 (7.7%) patients after the first botulinum toxin A injections.
authors.forename: O A
authors.initials: OA
authors.lastname: Klochkova
authors.forename: A L
authors.initials: AL
authors.lastname: Kurenkov
authors.forename: L S
authors.initials: LS
authors.lastname: Namazova-Baranova
authors.forename: A M
authors.initials: AM
authors.lastname: Mamed'iarov
authors.forename: K V
authors.initials: KV
authors.lastname: Zherdev
mesh_terms: D000293:Adolescent; D019274:Botulinum Toxins, Type A / Q000008:administration & dosage*; D002547:Cerebral Palsy / Q000188:drug therapy* / Q000534:rehabilitation*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007273:Injections, Intramuscular; D008297:Male; D009043:Motor Activity / Q000502:physiology*; D009048:Motor Skills / Q000502:physiology*; D009128:Muscle Spasticity / Q000188:drug therapy / Q000534:rehabilitation; D009465:Neuromuscular Agents / Q000008:administration & dosage; D013647:Task Performance and Analysis; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A