scholarly journals Is botulinum toxin type A more effective and safer than other treatments for the management of lower limb spasticity in children with cerebral palsy? A Cochrane Review summary with commentary

2021 ◽  
pp. 1-4
Author(s):  
Heakyung Kim ◽  
Kat Kolaski
Keyword(s):  
Cerebral Palsy ◽  
Botulinum Toxin ◽  
Lower Limb ◽  
Cochrane Review ◽  
Serial Casting ◽  
Children With Cerebral Palsy ◽  
Limb Spasticity ◽  
Lower Limb Spasticity ◽  
Gait Function ◽  
Quality Evidence

BACKGROUND: Botulinum toxin A (BoNT-A) is a well-accepted treatment for the medical management of spasticity in children with cerebral palsy (CP). OBJECTIVE: To assess the efficacy and safety of BoNT-A compared with other treatment options in managing lower limb spasticity in children with CP. METHODS: A summary of the Cochrane Review update by Blumetti et al. (2019), with comments. RESULTS: This review included 31 randomized controlled trials (1508 participants). Compared with usual care/physiotherapy, the evidence is very uncertain about the effect of BoNT-A on gait, function, ankle joint range of motion (ROM), satisfaction, and ankle spasticity in children with CP. Compared with placebo/sham, BoNT-A probably benefits these same outcomes, although the results for function are contradictory. BoNT-A may not be more effective than serial casting at improving gait, function, ankle ROM and spasticity at any time point. However, it may be more effective than an orthosis at medium-term follow-up for hip ROM and adductor spasticity, but not function. The rate of adverse events with BoNT-A is similar to placebo/sham and serial casting. CONCLUSIONS: Evidence for the effectiveness and safety of BoNT-A for the management of lower limb spasticity in children with CP is uncertain, with better quality evidence available from studies of placebo/sham than non-placebo controls. To produce high-quality evidence, future studies need to improve their methodological quality and increase sample sizes.

Botulinum Toxin for Lower Limb Spasticity in Children with Cerebral Palsy

2004 ◽  
Vol 83 (10) ◽  
pp. 766-773 ◽  
Author(s):  
Li-Rong Lee ◽  
Yao-Chia Chuang ◽  
Baii-Jia Yang ◽  
Min-Jung Hsu ◽  
Ying-Hung Liu
Keyword(s):  
Cerebral Palsy ◽  
Botulinum Toxin ◽  
Lower Limb ◽  
Children With Cerebral Palsy ◽  
Limb Spasticity ◽  
Lower Limb Spasticity

scholarly journals The Effect of Botulinum Toxin Injections on Gross Motor Function for Lower Limb Spasticity in Children with Cerebral Palsy

Toxins ◽  
2019 ◽  
Vol 11 (11) ◽  
pp. 651 ◽  
Author(s):  
Ja Young Choi ◽  
Seung Ki Kim ◽  
Eun Sook Park
Keyword(s):  
Cerebral Palsy ◽  
Botulinum Toxin ◽  
Motor Function ◽  
Lower Limb ◽  
Gross Motor ◽  
Gross Motor Function ◽  
Younger Age ◽  
Injection Type ◽  
Limb Spasticity ◽  
Lower Limb Spasticity

The aim of this study was to investigate the use of botulinum toxin type A (BoNT-A) injections and their efficacy on gross motor function for lower limb spasticity in children with spastic cerebral palsy (CP). This retrospective study included 919 injection occasions from 591 children with CP who received a lower limb BoNT-A injection between 2006 and 2016. The Gross Motor Function Measure (GMFM-88), the Modified Ashworth Scale, and the Modified Tardieu Scale were administered before and after injections. Injections were predominantly administered to children under the age of 6 years. The most common muscle injection site was the calf muscle for dynamic foot deformity. The second most commonly injected muscle was the hip adductor among 2–3 year olds and the hamstring muscle among 4–6 year olds. Distal injections were predominantly administered to high-functioning children, whereas proximal injections were typically administered to low-functioning children. Multilevel injections were mostly administered to midfunctioning children. GMFM-88 scores significantly increased post-injection for both high- and low-functioning groups. Younger age at injection and distal injection type were associated with larger improvements on the GMFM-88 at both short- and midterm follow-up. The target muscles for injection varied depending on gross motor functioning and age. Younger age at injection and distal injection type were significantly related with greater gain in gross motor function.

scholarly journals The Influence of Cryotherapy on the Lower Limb Spasticity for Children with Cerebral Palsy

2018 ◽  
Vol 2 (85) ◽  
Author(s):  
Saulė Sipavičenė ◽  
Antanas Damašauskas ◽  
Irina Klizienė ◽  
Gražina Krutulytė ◽  
Aiva Karpavičienė ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Physical Therapy ◽  
Lower Limb ◽  
Control Group ◽  
Gross Motor ◽  
Motor Functions ◽  
Physical Exercises ◽  
Children With Cerebral Palsy ◽  
Limb Spasticity ◽  
Lower Limb Spasticity

Research background and hypothesis. Cryotherapy could reduce spasticity for children with cerebral palsy.Research aim. The aim of this study was to determine the effect of cryotherapy on the lower limb spasticity for children with cerebral palsy.Research methods. Fourteen children with cerebral palsy spastic Diplegia aged 6–12 years were examined. The procedures of cryotherapy and physical therapy were applied to children in the test group (n = 7), and only physical therapy – for the members in the control group (n = 7). For all the subjects, the following procedures were performed before and after the research: foot extension measurements, the determination of the spasticity of flexors and selective foot motion, the estimation of balance and gross motor functions. Research  results.  After  physical  exercises  foot  extension  showed  improvement,  spasticity  of  foot  flexors reduced, foot selective movements, balance and gross motor functions improved. There was no statistical difference between the results in both groups.Discussion and conclusions. The influence of cryotherapy on the lower limb spasticity for children with cerebral palsy was not statistically significant.Keywords: spasticity, cryotherapy, physical exercises.

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