title: Changes in spastic muscle stiffness after botulinum toxin A injections as part of rehabilitation therapy in patients with spastic cerebral palsy.
abstract: OBJECTIVE
  To investigate changes in stiffness in the gastrocnemius (GCM) muscle following rehabilitation therapy and botulinum toxin type A (BTX-A) injections in patients with spastic cerebral palsy (CP).
  
  
  METHODS
  The study included 16 children with spastic CP (Group 1) and 17 healthy children (Group 2). The children with CP received BTX-A injections and underwent rehabilitation therapy. The GCM and soleus muscles of the CP group were evaluated according to the modified Ashworth scale (MAS). The thicknesses of the muscles were measured, and the elasticity score (ELX 2/1) index was calculated.
  
  
  RESULTS
  The ELX 2/1 indices of the gastromedialis (GM) and gastrolateralis (GL) were significantly higher in Group 1 than in Group 2 (p < 0.05). The ELX 2/1 indices in the GM and GL muscles in the CP group were found to have decreased 4 weeks after the procedure (p < 0.05). Furthermore, the mean MAS score of the ankle decreased, from 3.4 to 2.6 (p < 0.05). GM ELX 2/1 in Group 1 (post-treatment) was significantly different from Group 2 (p < 0.05).
  
  
  CONCLUSIONS
  The combined use of clinical scales and sonoelastography can provide valuable information for determining structural changes in the GCM muscle following rehabilitation therapy and BTX-A injections.
authors.affiliation: Harran University Medical School, Department of Physical Medicine and Rehabilitation, Sanliurfa, Turkey.
authors.forename: Ahmet
authors.initials: A
authors.lastname: Boyaci
authors.affiliation: Harran University Medical School, Department of Physical Medicine and Rehabilitation, Sanliurfa, Turkey.
authors.forename: Ahmet
authors.initials: A
authors.lastname: Tutoglu
authors.affiliation: Harran University Medical School, Department of Radiology, Sanliurfa, Turkey.
authors.forename: Nurefsan
authors.initials: N
authors.lastname: Boyaci
authors.affiliation: Gaziantep University Medical School, Department of Physical Medicine and Rehabilitation, Gaziantep, Turkey.
authors.forename: Irfan
authors.initials: I
authors.lastname: Koca
authors.affiliation: Harran University Medical School, Department of Pediatric Neurology, Sanliurfa, Turkey.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Calik
authors.affiliation: Harran University Medical School, Department of Physical Medicine and Rehabilitation, Sanliurfa, Turkey.
authors.forename: Ali
authors.initials: A
authors.lastname: Sakalar
authors.affiliation: Harran University Medical School, Department of Radiology, Sanliurfa, Turkey.
authors.forename: Nihat
authors.initials: N
authors.lastname: Kilicaslan
mesh_terms: D019274:Botulinum Toxins, Type A / Q000008:administration & dosage*; D002547:Cerebral Palsy / Q000175:diagnosis / Q000188:drug therapy* / Q000534:rehabilitation*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007273:Injections, Intramuscular; D008297:Male; D018482:Muscle, Skeletal / Q000000981:diagnostic imaging / Q000187:drug effects; D009465:Neuromuscular Agents / Q000008:administration & dosage*; D014463:Ultrasonography
chemical_list: D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A
keywords: Cerebral palsy; elasticity score index; gastrocnemius muscle; rehabilitation; spasticity