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[Botulinum toxin type A for the treatment of spasticity in children with cerebral palsy]
Lidija Dimitrijević1, Ivona Stanković, Vesna Zivković
1Klinicki centar Nis, Klinika za fizikalnu medicinu, rehabilitaciju i protetiku, Odeljenje za habilitaciju i rehabilitaciju dece, Bulevar Zorana Dindića 48, 18 000 Nis, Srbija. lidijad@bankerinter.net
Insights
Botulinum toxin type A (BTA) effectively reduces spasticity and improves range of motion in children with cerebral palsy. This treatment enhances functional motor outcomes, offering significant benefits for affected children.
Area of Science:
- Pediatric Neurology
- Rehabilitation Medicine
- Movement Disorders
Background:
- Cerebral palsy (CP) is a leading cause of childhood physical disability, characterized by limb spasticity leading to contractures and deformities.
- Botulinum toxin type A (BTA) is increasingly recognized for its therapeutic potential in managing CP symptoms.
Purpose of the Study:
- To evaluate the efficacy of BTA in improving spasticity, active range of motion, and functional motor outcomes in children diagnosed with spastic cerebral palsy.
Main Methods:
- A study involving 42 children (aged 2-6 years) with spastic CP, divided into two groups: BTA plus physical therapy (Group I) and physical therapy alone (Group II).
- Key parameters including spasticity, active range of motion (hip, knee, ankle), and functional motor outcomes were measured pre-treatment and at 3, 8, and 16 weeks post-treatment.
Main Results:
- No significant differences were observed between groups before treatment.
- Significant reductions in spasticity were noted in Group I by week 8 (p < 0.0001).
- Statistically significant improvements in active range of motion for hip abduction, knee extension, and foot dorsiflexion were observed in Group I by week 8 (p < 0.01).
- Functional motor outcomes showed significant improvement in Group I by week 16 (p < 0.05).
Conclusions:
- Botulinum toxin type A application demonstrates significant efficacy in reducing spasticity in children with CP.
- BTA treatment leads to notable increases in active range of motion.
- The study concludes that BTA positively impacts functional abilities in children with cerebral palsy.
Background/Aim:
Cerebral palsy (CP) is the most common physical disability in childhood. Children have problems with motor functions as a result of limbs spasticity, which leads to severe contractures and limbs deformity. There is a growing interest in the therapeutic role of botulinum toxin type A (BTA) in CP. The aim of this study was to examine the effects of BTA on spasticity, active range of motion and functional motor outcomes in children with CP.
Methods:
This study included 42 children of both sexes, aged 2-6 years, with spastic CP, divided into two groups: group I (21 child) treated with BTA and physical therapy, and group II (21 child) treated with physical therapy only. The following parameters were analyzed: spasticity; active range of motion of the hip, knee and ankle, and functional motor outcome. These parameters measurements were carried out four times in both groups: before the treatment, three, eight and 16 weeks after the beginning of the treatment. The obtained results were statistically processed and compared.
Results:
There was no evidence of any significant difference between the groups before the treatment. After eight weeks there was a remarkable difference concerning spasticity reducing on behalf of the group I (group I -- 0.76 +/- 0.51 vs. II group -- 2.17 +/- 0.64; p < 0.0001). There was statistically significant difference concerning active range of motion increasing on behalf of the group I (hip abduction: group I --44.37 +/- 1.13(0) vs. group II -- 32.61 +/- 8.07(0),p < 0,01; knee extension: group I -- 0.77 +/- 1.82(0) vs. II group -- 14.99 +/- 7.61(0), p < 0.01; dorsiflexion of the foot: group I -- 11.50 +/- 6.08(0) vs. group II -- 8.98 +/- 7.85(0), p < 0.01). A statistically significant difference was found after 16 weeks in functional motor outcome as well, on behalf of the group I: functional motor abilities level in the group I was 1.86 vs. 2.71 in the group II, p < 0.05.
Conclusion:
Botulinum toxin type A application leads to an important spasticity decreasing, active range of motion increasing, as well as to functional abilities in children with CP.
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