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Physical therapy intervention for children with cerebral palsy who receive botulinum toxin a injections

Margaret E O'Neil1, Maria A Fragala, Helene M Dumas

  • 1Drexel University, College of Nursing and Health Professions, Hahnemann Programs in Rehabilitation Sciences, Philadelphia, PA 19102, USA. moneil@drexel.edu

Pediatric Physical Therapy : the Official Publication of the Section on Pediatrics of the American Physical Therapy Association
|October 24, 2006
PubMed

Insights

Physical therapy (PT) for children with cerebral palsy (CP) and lower extremity spasticity often increases after botulinum toxin A (BtA) injections. Therapists utilize impairment- and function-based strategies to achieve functional goals.

Area of Science:

  • Pediatric Physical Therapy
  • Neuromuscular Rehabilitation
  • Spasticity Management

Background:

  • Cerebral palsy (CP) is a common cause of childhood motor disability.
  • Lower extremity spasticity impacts functional mobility in children with CP.
  • Botulinum toxin A (BtA) injections are used to manage spasticity.

Purpose of the Study:

  • To describe changes in physical therapy (PT) service delivery after BtA injections in children with CP.
  • To identify shifts in PT intervention strategies and anticipated goals post-BtA.
  • To analyze PT modifications for lower extremity spasticity in pediatric CP.

Main Methods:

  • Six physical therapists (PTs) treating children with CP undergoing BtA injections were interviewed.
  • A structured telephone interview collected data over a six-month period (2 months pre-injection, 4 months post-injection).
  • Descriptive analysis examined changes in PT delivery and interventions over time.

Main Results:

  • Three therapists reported an increase in PT frequency post-BtA injection.
  • Intervention trends showed a move towards impairment- and function-based strategies.
  • Goals primarily focused on achieving functional improvements.

Conclusions:

  • BtA injections can influence the intensity and focus of PT for pediatric CP.
  • PT interventions evolve post-BtA to target specific impairments and enhance function.
  • Functional outcomes are the main emphasis for goal setting in this population.
Abstract

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