title: Intrinsic properties and functional changes in spastic muscle after application of BTX-A in children with cerebral palsy: systematic review.
abstract: OBJECTIVE
  This article aimed to review the literature to verify the effect of botulinum toxin type A (BTX-A) on the intrinsic properties of spastic muscles and functionality in children with cerebral palsy (CP).
  
  
  METHODS
  A literature search was conducted in the following databases: CINAHL, SCOPUS, Web of Science and PubMed. Database searches were limited to the period from January 1993 to March 2014.
  
  
  RESULTS
  A total of 2182 papers were identified, and 17 met the inclusion criteria. Only one study analyzed the effect of the toxin on muscle intrinsic properties and others analyzed the effect on functionality.
  
  
  CONCLUSIONS
  BTX-A application demonstrated no changes in the passive stiffness of spastic muscle. In relation to functional level, the evidence of BTX-A effect was controversial. These studies showed methodological quality limitations that restrict the interpretation of the results for the entire CP population, which justifies the need for further randomized controlled trials.
authors.affiliation: Department of Physical Therapy, Laboratory of Neurological Physiotherapy Research, Federal University of São Carlos (UFSCar) , São Carlos, SP , Brazil and.
authors.forename: Luisa Fernanda
authors.initials: LF
authors.lastname: García Salazar
authors.forename: Gabriela Lopes
authors.initials: GL
authors.lastname: dos Santos
authors.forename: Silvia Letícia
authors.initials: SL
authors.lastname: Pavão
authors.forename: Nelci Adriana Cicuto Ferreira
authors.initials: NA
authors.lastname: Rocha
authors.forename: Thiago Luiz
authors.initials: TL
authors.lastname: de Russo
mesh_terms: D000293:Adolescent; D019274:Botulinum Toxins, Type A / Q000008:administration & dosage / Q000627:therapeutic use*; D002547:Cerebral Palsy / Q000188:drug therapy*; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007273:Injections, Intramuscular; D009128:Muscle Spasticity / Q000188:drug therapy*; D009465:Neuromuscular Agents / Q000008:administration & dosage / Q000627:therapeutic use*
chemical_list: D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A
keywords: Botulinum toxin; functionality; motor developmental; muscle spasticity; rehabilitation