An evaluation of botulinum-A toxin injections to improve upper extremity function in children with hemiplegic...

Area of Science:

• Pediatric Neurology
• Rehabilitation Medicine
• Movement Disorders

Background:

• Spastic hemiplegia in children significantly impacts upper extremity function and daily activities.
• Botulinum-A toxin (BTA) is a neurotoxin used to reduce muscle spasticity.
• Effective interventions are needed to improve functional outcomes in affected children.

Purpose of the Study:

• To evaluate the efficacy of botulinum-A toxin (BTA) injections in improving upper extremity function in children with spastic hemiplegia.
• To compare outcomes between children receiving BTA injections plus occupational therapy and those receiving occupational therapy alone.

Main Methods:

• A randomized, controlled, single-blind trial involving 30 children (aged 2.5-10 years) with hemiplegia.
• Participants were assigned to either BTA injections (targeting biceps, forearm, or thumb muscles) plus occupational therapy, or occupational therapy alone.
• Outcomes measured included the Quality of Upper Extremity Skills Test (QUEST), goniometry, grip strength, Ashworth scores, and the Pediatric Evaluation of Disability Inventory (PEDI) self-care domain.

Main Results:

• The group receiving BTA injections showed a statistically significant improvement in the QUEST scores compared to the control group (P=.039).
• Significant improvements were also observed in the self-care domain of the PEDI for the BTA treatment group (P=.04).
• Twenty-nine of thirty participants completed the study.

Conclusions:

• Botulinum-A toxin injections, when combined with occupational therapy, are effective in enhancing upper extremity function in children with spastic hemiplegia.
• The findings support BTA as a valuable therapeutic option for children with moderate to severe spasticity affecting their upper limbs.