Motor function following multilevel botulinum toxin type A treatment in children with cerebral palsy

✍ Scribed by Kaat Desloovere; Guy Molenaers; Jos De Cat; Petra Pauwels; Anja Van Campenhout; Els Ortibus; Guy Fabry; Paul De Cock

• Publisher: John Wiley and Sons
• Year: 2006
• Tongue: English
• Weight: 292 KB
• Volume: 49
• Category: Article
• ISSN: 0012-1622
• DOI: 10.1017/s001216220700014x.x

✦ Synopsis

This study evaluated the effects of multilevel botulinum toxin type A (BTX‐A) treatments on the gait pattern of children with spastic cerebral palsy (Gross Motor Function Classification System Levels I‐III). In this nested case—control design, 30 children (mean age 6y 11mo [SD 1y 5mo]; 21 males, nine females; 19 with hemiplegia, 11 with diplegia) were treated according to best practice guidelines in paediatric orthopaedics, including BTX‐A injections. A matched control group of 30 children (mean age 7y 8mo [SD 1y 10mo]; 13 males, 17 females; 19 with hemiplegia, 11 with diplegia) were treated identically, but without BTX‐A. Motor development status at 5 to 10 years of age was assessed by means of three‐dimensional gait analysis at a mean time of 1 year 10 months (SD 10mo) after the last BTX‐A treatment. The control group showed a significantly more pronounced pathological gait pattern than the BTX‐A group. Major differences were found for pelvic anterior tilt, maximum hip and knee extension, and internal hip rotation. These results provide evidence for a prolonged effect of BTX‐A and suggest that BTX‐A injections, in combination with common conservative treatment options, result in a gait pattern that is less defined by secondary problems (e.g. bony deformities) at 5 to 10 years of age, minimizing the need for complex surgery at a later age and enhancing quality of life.