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Upper extremity function and occupational performance in children with spastic cerebral palsy following lower
Tal Keren-Capelovitch1, Tal Jarus, Aviva Fattal-Valevski
1Department of Occupational Therapy, Stanley Steyer School of Health Professions, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel. tlnzvkrn@netvision.net.il
Insights
Botulinum toxin A injections in the lower limbs of children with spastic cerebral palsy significantly improved upper limb function and daily tasks for at least six months. This treatment enhances overall occupational performance in affected children.
Area of Science:
- Neurology
- Pediatrics
- Rehabilitation Medicine
Background:
- Spastic cerebral palsy (CP) often impacts motor function in both lower and upper limbs.
- Occupational performance and upper limb function are crucial for daily living activities in children with CP.
- Botulinum toxin A injections are commonly used to manage spasticity in CP, primarily targeting lower limbs.
Purpose of the Study:
- To investigate the effect of botulinum toxin A injections to the lower extremities on upper limb body function and occupational performance in children with spastic cerebral palsy.
- To determine the duration of any observed functional improvements.
Main Methods:
- A cohort of 16 children (aged 2-8 years, GMFCS levels I-IV) with spastic CP received botulinum toxin A injections to their lower limbs.
- Assessments were conducted 1 month pre-injection, immediately pre-injection, and 1 and 5-6 months post-injection.
- Evaluated outcomes included everyday function (Canadian Occupational Performance Measure, Pediatric Evaluation of Disability Inventory) and upper extremity function (Quality of Upper Extremity Skills Test).
Main Results:
- Significant improvements in upper limb body function and occupational performance were observed between the immediate pre-injection and the two post-injection assessments.
- These functional gains were sustained for at least 6 months post-injection.
- Botulinum toxin A injections to the lower extremities positively impacted upper limb function and daily activities.
Conclusions:
- Botulinum toxin A injections targeting the lower extremities can lead to meaningful improvements in upper limb function and occupational performance in children with spastic cerebral palsy.
- The benefits of these injections extend beyond spasticity management in the lower limbs, positively influencing overall functional capacity.
- This approach offers a potential therapeutic strategy to enhance the daily lives and participation of children with cerebral palsy.
Abstract:
We studied the effect of botulinum toxin A injections to the lower extremities of spastic cerebral palsy children on upper limb body function and occupational performance. A total of 16 children with spastic cerebral palsy, aged 2 to 8 years, Gross Motor Function Classification System levels I-IV, referred to a child neurology outpatient clinic for botulinum toxin A injections to the lower limbs, underwent 4 assessments: 1 month prior to injection, immediate pre injection, and at 1 and 5 to 6 months post injection. Three tools were used to test everyday function (Canadian Occupational Performance Measure and the Pediatric Evaluation of Disability Inventory) and upper extremity body function (Quality of Upper Extremity Skills Test). Significant improvement was documented between the immediate preinjection and the 2 postinjection assessments, indicating that improvement lasted for at least 6 months. Botulinum toxin A injections to the lower extremities in children with cerebral palsy improve upper limb body function and occupational performance.
