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A prospective study investigating gross motor function of children with cerebral palsy and GMFCS level II after
Jane Valentine1,2, Sue-Anne Davidson3, Natasha Bear4
1School of Medicine, University of Western Australia, 35 Stirling Highway, Crawley, Western Australia, 6009, Australia. jane.valentine@health.wa.gov.au.
Insights
Children with Cerebral Palsy (CP) receiving Botulinum toxin A injections show maintained or improved gross motor function. This evidence-based intervention supports long-term functional outcomes in pediatric CP patients.
Area of Science:
- Pediatric neurology
- Rehabilitation medicine
- Developmental pediatrics
Background:
- Cerebral Palsy (CP) significantly impacts gross motor function in children and adolescents.
- Long-term outcomes of medical interventions for pediatric CP require further investigation.
- Understanding the effectiveness of treatments like Botulinum toxin A is crucial for improving patient care.
Purpose of the Study:
- To assess the long-term effects of Botulinum toxin A on gross motor function in children with CP.
- To contribute to the knowledge base regarding evidence-based interventions for pediatric CP.
- To evaluate functional motor level changes in young CP patients treated with Botulinum toxin A.
Main Methods:
- Prospective cohort study design.
- Inclusion of children diagnosed with CP, born between 2000-2009, with an initial Gross Motor Function Classification System (GMFCS) level of II.
- Analysis of Botulinum toxin A treatment details and GMFCS level recordings over time.
Main Results:
- Out of 40 eligible children, 28 (72.7%) enrolled in the study.
- Children received a median of 11 lower limb Botulinum toxin A injections.
- 21.4% of children improved from GMFCS level II to level I, while 78.6% remained at level II.
Conclusions:
- Repeated Botulinum toxin A treatment in young children with CP (GMFCS level II) leads to maintained or improved functional motor levels.
- Integrated, comprehensive care combined with Botulinum toxin A is effective for long-term motor function in pediatric CP.
- This study confirms the positive impact of early, consistent intervention on gross motor function in children with CP.
Background:
The aim of this study is to contribute to the knowledge base on the long-term outcomes of evidence-based medical interventions used to improve gross motor function in children and adolescents with Cerebral Palsy.
Method:
Prospective cohort study of children with Cerebral Palsy in the birth years 2000-2009 attending a tertiary level service for children with Cerebral Palsy who's first recorded Gross Motor Function Classification System level was II.
Results:
A total of 40 children were eligible for the study, of whom 28 (72.7%) enrolled. The Botulinum toxin A treatment for this cohort, (median and interquartile ranges) were: total number of lower limb Botulinum toxin A injections 11 (6.7, 5.5); total dose of Botulinum Toxin A per lower limb treatment 6.95 u/kg (4.5, 11); and dose of Botulinum Toxin u/kg/muscle 2.95 (2.2, 4). For all 28 subjects there was a median of 15 (8.5 to 22) Gross Motor Function Classification System level recordings: six of the 28 children (21.4%) improved from level II to level I, the remaining 22 children remained stable at level II (78.6%). In this highly treated population, the average 66 item Gross Motor Function Measure score for the 22 children in level II was 72.55, which is consistent with the mean of 68.5 reported in the original Ontario cohort.
Conclusion:
This cohort study has confirmed that children with Cerebral Palsy, Gross Motor Function level II treated at a young age with repeated doses of Botulinum Toxin A within an integrated comprehensive service, maintain or improve their functional motor level at a later age.
