The effects of botulinum toxin type A on improvement and dynamic spastic equinus correction in children with cerebral palsy - preliminary results.
BACKGROUND
We evaluated the effects of botulinum toxin type A (BTA) with physical therapy on dynamic foot equinus correction and higher motor functional outcome in children with spastic type of cerebral palsy (CP).


METHODS
Ankle joint active and passive movement, gastrocnemial muscle spasticity levels (Modified Ashworth Scale (MAS)), and higher motor functional status (Gross Motor Function Classification System (GMFCS) and Gross Motor Function Measure (GMFM) (GMFM-D - standing and GMFM-E - walking) were assessed before treatment and 3, 8, 16 weeks and 6 months after BTA administration in 12 children.


RESULTS
There was a significant improvement of active (initial - (-)13.07 ±5.78; 6 months - (-)10.64 ±4.77; p < 0.001) and passive (initial - 4.21 ±2.29; 6 months - 4.71 ±2.16; p < 0.05) ankle joint foot dorsiflexion. GMFM-D and GMFM-E were significantly higher after 3, 8, 16 weeks (p < 0.001) and GMFM-D after 6 months (p < 0.001).


CONCLUSIONS
Botulinum toxin type A administration and physical therapy in patients with spastic CP improves the motion range of dynamic foot equinus after 3 weeks and higher motor functional outcome (standing and walking).
Clinic for Physical Therapy and Rehabilitation, Clinical Centre of Nis, Nis, Serbia.
Hristina
H
Colovic
Clinic for Physical Therapy and Rehabilitation, Clinical Centre of Nis, Nis, Serbia ; Faculty of Medicine, University of Nis, Nis, Serbia.
Lidija
L
Dimitrijevic
Clinic for Physical Therapy and Rehabilitation, Clinical Centre of Nis, Nis, Serbia ; Faculty of Medicine, University of Nis, Nis, Serbia.
Ivona
I
Stankovic
Physical Medicine and Rehabilitation, University Children's Hospital, Belgrade, Serbia.
Dejan
D
Nikolic
Faculty of Medicine, University of Nis, Nis, Serbia ; Gynecology and Obstetrics Clinic, Clinical Centre of Nis, Nis, Serbia.
Dragana
D
Radovic-Janosevic
Faculty of Medicine, University of Nis, Nis, Serbia ; Pediatric Surgery Clinic, Clinical Centre of Nis, Nis, Serbia.
Dragoljub
D
Zivanovic
botulinum toxin; cerebral palsy; dynamic equines