Effect of combined rehabilitation program with botulinum toxin type A injections on gross motor function scores in children with spastic cerebral palsy

[Purpose] To examine whether combining botulinum toxin type A with physiotherapy is better than botulinum toxin type A alone in reducing muscle tone and improving gross motor function in spastic diplegia. [Subjects and Methods] Forty-six ambulatory children with spastic diplegia (age: 25–154 months)...

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Autores principales: Flemban, Abeer, Elsayed, Walaa
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Society of Physical Therapy Science 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6047965/
https://www.ncbi.nlm.nih.gov/pubmed/30034093
http://dx.doi.org/10.1589/jpts.30.902
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author Flemban, Abeer
Elsayed, Walaa
author_facet Flemban, Abeer
Elsayed, Walaa
author_sort Flemban, Abeer
collection PubMed
description [Purpose] To examine whether combining botulinum toxin type A with physiotherapy is better than botulinum toxin type A alone in reducing muscle tone and improving gross motor function in spastic diplegia. [Subjects and Methods] Forty-six ambulatory children with spastic diplegia (age: 25–154 months) were recruited. Patients were assigned to Groups 1 (n=18) and 2 (n=28). After baseline assessment, all children received botulinum toxin type A injections (6 units/kg) into the lower limb muscles. A second botulinum toxin type A injection was given 6 months later. The ankles were placed in plaster casts for 2 weeks after the first injection and an orthosis was prescribed after cast removal. Group 2 received 2 weeks of intensive physiotherapy. The gross motor function scores for the 2 groups were recorded at baseline, 4, 6, and 52 weeks. [Results] The improvement in gross motor function scores was significant for Group 2 and non-significant for Group 1. After 4, 6, and 52 weeks, Groups 1 and 2 showed 2.6% and 6.3% improvement, 4.8% and 12% improvement, and 5.5% and 19.4% improvement, respectively. [Conclusion] The addition of a 2-week physiotherapy programme after the initial botulinum toxin type A injections produced significantly greater improvements in gross motor function scores.
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spelling pubmed-60479652018-07-20 Effect of combined rehabilitation program with botulinum toxin type A injections on gross motor function scores in children with spastic cerebral palsy Flemban, Abeer Elsayed, Walaa J Phys Ther Sci Original Article [Purpose] To examine whether combining botulinum toxin type A with physiotherapy is better than botulinum toxin type A alone in reducing muscle tone and improving gross motor function in spastic diplegia. [Subjects and Methods] Forty-six ambulatory children with spastic diplegia (age: 25–154 months) were recruited. Patients were assigned to Groups 1 (n=18) and 2 (n=28). After baseline assessment, all children received botulinum toxin type A injections (6 units/kg) into the lower limb muscles. A second botulinum toxin type A injection was given 6 months later. The ankles were placed in plaster casts for 2 weeks after the first injection and an orthosis was prescribed after cast removal. Group 2 received 2 weeks of intensive physiotherapy. The gross motor function scores for the 2 groups were recorded at baseline, 4, 6, and 52 weeks. [Results] The improvement in gross motor function scores was significant for Group 2 and non-significant for Group 1. After 4, 6, and 52 weeks, Groups 1 and 2 showed 2.6% and 6.3% improvement, 4.8% and 12% improvement, and 5.5% and 19.4% improvement, respectively. [Conclusion] The addition of a 2-week physiotherapy programme after the initial botulinum toxin type A injections produced significantly greater improvements in gross motor function scores. The Society of Physical Therapy Science 2018-07-03 2018-07 /pmc/articles/PMC6047965/ /pubmed/30034093 http://dx.doi.org/10.1589/jpts.30.902 Text en 2018©by the Society of Physical Therapy Science. Published by IPEC Inc. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives (by-nc-nd) License. (CC-BY-NC-ND 4.0: https://creativecommons.org/licenses/by-nc-nd/4.0/)
spellingShingle Original Article
Flemban, Abeer
Elsayed, Walaa
Effect of combined rehabilitation program with botulinum toxin type A injections on gross motor function scores in children with spastic cerebral palsy
title Effect of combined rehabilitation program with botulinum toxin type A injections on gross motor function scores in children with spastic cerebral palsy
title_full Effect of combined rehabilitation program with botulinum toxin type A injections on gross motor function scores in children with spastic cerebral palsy
title_fullStr Effect of combined rehabilitation program with botulinum toxin type A injections on gross motor function scores in children with spastic cerebral palsy
title_full_unstemmed Effect of combined rehabilitation program with botulinum toxin type A injections on gross motor function scores in children with spastic cerebral palsy
title_short Effect of combined rehabilitation program with botulinum toxin type A injections on gross motor function scores in children with spastic cerebral palsy
title_sort effect of combined rehabilitation program with botulinum toxin type a injections on gross motor function scores in children with spastic cerebral palsy
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6047965/
https://www.ncbi.nlm.nih.gov/pubmed/30034093
http://dx.doi.org/10.1589/jpts.30.902
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