Effect of botulinum toxin type A treatment in children with cerebral palsy: Sequential physical changes for 3 months...

Area of Science:

• Pediatric Orthopedics
• Neuromuscular Rehabilitation
• Biomechanical Analysis

Background:

• Cerebral palsy (CP) often leads to motor impairments, affecting gait and joint mobility.
• Botulinum toxin type A (BTX-A) injections are used to manage spasticity in children with CP.
• Understanding the temporal effects of BTX-A on physical function is crucial for optimizing treatment strategies.

Purpose of the Study:

• To investigate the sequential physical changes following botulinum toxin type A (BTX-A) injections in pediatric patients with cerebral palsy.
• To document the timeline of functional improvements and biomechanical alterations after BTX-A treatment.

Main Methods:

• Nine children diagnosed with cerebral palsy participated in the study.
• Gait analysis in the sagittal plane was performed at baseline and at 4, 8, and 12 weeks post-treatment.
• Measurements included joint range of motion (ROM), gait parameters (step length, speed), observational gait scales (FCS, PRS), lower limb ROM, Modified Tardieu Scale (MTS), knee extension torque, and Gross Motor Function Measure-66 (GMFM-66).

Main Results:

• Significant increases in ankle dorsiflexion range of motion (ROM) and the maximum ankle dorsiflexion angle during gait were observed at 8 weeks post-treatment.
• Improvements in the Gross Motor Function Measure-66 (GMFM-66) were also noted at the 8-week mark.
• A significant increase in knee joint extension torque was evident at 12 weeks post-treatment.

Conclusions:

• The peak therapeutic effects of BTX-A treatment in children with cerebral palsy manifest later than initially expected, beyond the early post-treatment phase.
• Optimizing rehabilitation timing, with longer intervention periods integrated with BTX-A treatment, may yield superior functional outcomes compared to short-term rehabilitation protocols.