The influence of physical therapy and anti-botulinum toxin antibody on the efficacy of botulinum toxin-A injections in children with spastic cerebral palsy.
OBJECTIVE
To identify factors associated with the efficacy of botulinum toxin-A (BoNT-A) injections.


METHODS
Thirty-eight children with spastic cerebral palsy (CP) received BoNT-A injections into the gastrocnemius. The baseline anti-botulinum antibodies were checked. The Static dorsiflexion range of motion (ROM), Modified Tardieu Scale (MTS) and Physician Rating Scale (PRS) were assessed at pre-injection as well as 4- and 12-week post-injection.


RESULTS
No samples contained anti-botulinum antibodies. Greater baseline MTS dynamic range was associated with greater changes in MTS dynamic ranges at 4-week post-injection. More frequent physical therapy was associated with greater changes in static dorsiflexion ROM at 4-week post-injection and greater changes in PRS at 4- and 12-week post-injection.


CONCLUSIONS
The improvement in PRS at 12-week post-injection was associated with the frequency of physical therapy. Therefore, intensive physical therapy programs may be necessary to maintain the beneficial effects of BoNT-A injections in children with CP.
Department of Rehabilitation, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea , Incheon , Korea and.
Dae-Hyun
DH
Jang
In Young
IY
Sung
D000293:Adolescent; D000906:Antibodies / Q000737:chemistry; D001905:Botulinum Toxins / Q000008:administration & dosage*; D019274:Botulinum Toxins, Type A / Q000627:therapeutic use*; D002547:Cerebral Palsy / Q000188:drug therapy* / Q000534:rehabilitation; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D009128:Muscle Spasticity / Q000188:drug therapy; D018482:Muscle, Skeletal / Q000187:drug effects; D009465:Neuromuscular Agents / Q000008:administration & dosage*; D026741:Physical Therapy Modalities; D011446:Prospective Studies; D016059:Range of Motion, Articular; D012044:Regression Analysis; D013997:Time Factors; D016896:Treatment Outcome
D000906:Antibodies; D009465:Neuromuscular Agents; D001905:Botulinum Toxins; D019274:Botulinum Toxins, Type A
Antibodies; cerebral palsy; spasticity; toxin type A; treatment outcomes