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[Botulinum toxin A and physical therapy in gait in cerebral palsy]
Sandra Fabiola García-Sánchez1, María Teresa Gómez-Galindo, Jaime Eduardo Guzmán-Pantoja
1Departamento de Rehabilitación, Hospital General Regional No. 180, Instituto Mexicano del Seguro Social, Tlajomulco de Zúñiga, Jalisco, México. gassmed09@gmail.com.
Insights
Botulinum toxin type A (TBA) effectively improves gait function and mobility in children with cerebral palsy (CP). This treatment, combined with physical therapy, showed sustained improvements in ankle mobility and gait patterns for up to four months.
Area of Science:
- Neurology
- Pediatrics
- Rehabilitation Medicine
Background:
- Cerebral palsy (CP) is a primary cause of childhood disability.
- Botulinum toxin type A (TBA) is utilized to enhance gait function in CP patients.
- Limited studies quantify TBA's impact on gait improvement.
Purpose of the Study:
- To evaluate the effectiveness of Botulinum toxin type A (TBA) in improving gait functionality and mobility in children with spastic cerebral palsy (CP).
- To quantify the changes in gait parameters, muscle tone, and passive joint mobility following TBA treatment and physical therapy.
Main Methods:
- A quasi-experimental study involving 36 spastic CP patients (ages 2-12).
- Evaluations included the Koman scale for gait functionality, Ashworth scale for muscle tone, and passive range of motion for ankles.
- Patients received TBA injections followed by 10 physical therapy sessions, with assessments at baseline, 1 month, and 4 months.
Main Results:
- 30 patients completed the study.
- Significant improvements were observed in gait functionality, muscle tone, and ankle dorsiflexion/abduction.
- These functional gains were maintained at the 4-month follow-up.
Conclusions:
- Botulinum toxin type A is an effective therapeutic option for enhancing mobility and gait in pediatric patients with hemiparetic and spastic paraparetic cerebral palsy.
- TBA treatment, alongside physical therapy, leads to increased passive joint mobility and improved gait functionality.
Background:
Cerebral palsy (PCI) is the leading cause of disability in children. Botulinum toxin type A (TBA) is a treatment to improve the function and pattern in the gait, although with a few studies that quantify the improvement.
Methods:
Quasi-experimental study was conducted from May 2010 to September 2011, in Integrated Rehabilitation Center, in 36 patients with spastic PCI. Was evaluated: functionality of travel by the scale of Koman, speed of the gait with tone scale of Ashworth and arches of passive mobility, were applied TBA and was sent to 10 sessions of physical therapy, with measurements taken before, the 1st and 4th month.
Results:
30 Patients completed the study, between the ages of 2 and 12 years, the majority had improvement in the functionality of the gear, tone, dorsiflexion and abduction of ankles to the motion, which was maintained at 4 months.
Conclusions:
Botulinum toxin is an effective treatment to increase the arches of mobility and functionality of the gait of patients with hemiparesis and spastic paraparesis.
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