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Related Experiment Videos

Botulinum toxin A in hamstring spasticity.

I S Corry1, A P Cosgrove, C M Duffy

  • 1Department of Orthopaedic Surgery, Royal Belfast Hospital for Sick Children and Musgrave Park Hospital, Belfast, UK.

Gait & Posture
|November 24, 1999
PubMed
Summary
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Botulinum toxin A injections in hamstrings improved knee extension in children with cerebral palsy temporarily. Caution is advised due to potential pelvic tilt changes and limited impact on walking energy cost.

Area of Science:

  • Orthopedics
  • Neurology
  • Pediatrics

Background:

  • Flexed knee gait in cerebral palsy often necessitates interventions like hamstring lengthening.
  • Botulinum toxin A (BtA) injections offer a potential conservative management strategy or surgical simulation.
  • Understanding BtA's short-term effects on gait mechanics is crucial for clinical decision-making.

Purpose of the Study:

  • To evaluate the efficacy of hamstring Botulinum toxin A injections in children with cerebral palsy.
  • To assess the impact on knee extension, gait parameters, and patient satisfaction.
  • To explore potential benefits and risks associated with this intervention.

Main Methods:

  • Ten children requiring future hamstring lengthening underwent Botulinum toxin A injections.

Related Experiment Videos

  • Short-term outcomes were assessed using clinical examination and 3-D gait analysis.
  • Key metrics included popliteal angle, knee extension in stance, pelvic tilt, and energy cost of walking.

    • Main Results:

    • A significant decrease in mean popliteal angle (16 degrees) and increase in maximum knee extension (8 degrees) were observed.
    • The improvement in knee extension relapsed by 12 weeks.
    • Increased pelvic tilt was noted, suggesting caution with isolated hamstring weakening; energy cost of walking remained unchanged in most patients.

    Conclusions:

    • Hamstring BtA injections can provide temporary improvements in knee extension for children with cerebral palsy.
    • Isolated hamstring weakening requires careful consideration due to potential compensatory changes like increased pelvic tilt.
    • Further research into associated muscle growth and long-term effects is warranted.