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A randomized controlled trial to compare two botulinum toxin injection techniques on the functional improvement of the leg of children with cerebral palsy.
Clin Rehabil 2009; 23(9):800-11CR

Abstract

OBJECTIVE

To compare the efficacy of botulinum toxin type A injection guided by different localizing techniques, electrical stimulation and palpation, to treat spasticity of the ankle plantar flexors.

DESIGN

Randomized controlled trial.

SETTING

Hospital neurology and rehabilitation department.

PARTICIPANTS

Sixty-five children with spastic hemiplegic or diplegic cerebral palsy.

INTERVENTIONS

Botulinum toxin injection guided by electrical stimulation or palpation, and two weeks of physiotherapy.

MAIN OUTCOME MEASURES

Passive range of movement (ROM), modified Ashworth Scale, Composite Spasticity Scale, D and E dimensions of the Gross Motor Function Measure, walking velocity.

RESULTS

Three groups improved significantly (P<50.05). The mean improvements between baseline and the end of follow-up were respectively 20, 16.2 and 11.9 degrees for passive ROM, -1.9, -1.4 and -0.7 for modified Ashworth Scale scores, -5.8, -4.2 and -2.3 for Composite Spasticity Scale scores, 18.6, 11.3 and 6.9 for Gross Motor Function Measure scores, and 0.2, 0.1 and 0.1 m/s for walking velocity in the botulinum toxin group guided by electrical stimulation injection plus physiotherapy, the botulinum toxin group guided by palpation injection plus physiotherapy, and the physiotherapy only group. The botulinum toxin injection guided by electrical stimulation group showed greater improvement in passive ROM (P<50.05), modified Ashworth Scale scores (P<50.05), Composite Spasticity Scale scores (P<50.05), and Gross Motor Function Measure scores (P<50.05) than the other two groups after treatment for three months.

CONCLUSIONS

Botulinum toxin injection guided by electrical stimulation plus physiotherapy is likely to be best in improving spasticity and functional performance in children with cerebral palsy.

Authors+Show Affiliations

Department of Neurology and Rehabilitation, Guangzhou Children's Hospital and Department of Rehabilitation Medicine, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou 510120, China.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

19482892

Citation

Kaishou Xu, , et al. "A Randomized Controlled Trial to Compare Two Botulinum Toxin Injection Techniques On the Functional Improvement of the Leg of Children With Cerebral Palsy." Clinical Rehabilitation, vol. 23, no. 9, 2009, pp. 800-11.
Kaishou Xu , Tiebin Yan , Jianning Mai . A randomized controlled trial to compare two botulinum toxin injection techniques on the functional improvement of the leg of children with cerebral palsy. Clin Rehabil. 2009;23(9):800-11.
Kaishou Xu, ., Tiebin Yan, ., & Jianning Mai, . (2009). A randomized controlled trial to compare two botulinum toxin injection techniques on the functional improvement of the leg of children with cerebral palsy. Clinical Rehabilitation, 23(9), pp. 800-11. doi:10.1177/0269215509335295.
Kaishou Xu , Tiebin Yan , Jianning Mai . A Randomized Controlled Trial to Compare Two Botulinum Toxin Injection Techniques On the Functional Improvement of the Leg of Children With Cerebral Palsy. Clin Rehabil. 2009;23(9):800-11. PubMed PMID: 19482892.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A randomized controlled trial to compare two botulinum toxin injection techniques on the functional improvement of the leg of children with cerebral palsy. AU - Kaishou Xu,, AU - Tiebin Yan,, AU - Jianning Mai,, Y1 - 2009/05/29/ PY - 2009/6/2/entrez PY - 2009/6/2/pubmed PY - 2009/11/5/medline SP - 800 EP - 11 JF - Clinical rehabilitation JO - Clin Rehabil VL - 23 IS - 9 N2 - OBJECTIVE: To compare the efficacy of botulinum toxin type A injection guided by different localizing techniques, electrical stimulation and palpation, to treat spasticity of the ankle plantar flexors. DESIGN: Randomized controlled trial. SETTING: Hospital neurology and rehabilitation department. PARTICIPANTS: Sixty-five children with spastic hemiplegic or diplegic cerebral palsy. INTERVENTIONS: Botulinum toxin injection guided by electrical stimulation or palpation, and two weeks of physiotherapy. MAIN OUTCOME MEASURES: Passive range of movement (ROM), modified Ashworth Scale, Composite Spasticity Scale, D and E dimensions of the Gross Motor Function Measure, walking velocity. RESULTS: Three groups improved significantly (P<50.05). The mean improvements between baseline and the end of follow-up were respectively 20, 16.2 and 11.9 degrees for passive ROM, -1.9, -1.4 and -0.7 for modified Ashworth Scale scores, -5.8, -4.2 and -2.3 for Composite Spasticity Scale scores, 18.6, 11.3 and 6.9 for Gross Motor Function Measure scores, and 0.2, 0.1 and 0.1 m/s for walking velocity in the botulinum toxin group guided by electrical stimulation injection plus physiotherapy, the botulinum toxin group guided by palpation injection plus physiotherapy, and the physiotherapy only group. The botulinum toxin injection guided by electrical stimulation group showed greater improvement in passive ROM (P<50.05), modified Ashworth Scale scores (P<50.05), Composite Spasticity Scale scores (P<50.05), and Gross Motor Function Measure scores (P<50.05) than the other two groups after treatment for three months. CONCLUSIONS: Botulinum toxin injection guided by electrical stimulation plus physiotherapy is likely to be best in improving spasticity and functional performance in children with cerebral palsy. SN - 1477-0873 UR - https://www.unboundmedicine.com/medline/citation/19482892/A_randomized_controlled_trial_to_compare_two_botulinum_toxin_injection_techniques_on_the_functional_improvement_of_the_leg_of_children_with_cerebral_palsy_ L2 - http://journals.sagepub.com/doi/full/10.1177/0269215509335295?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -