Effectiveness of Botulinum Toxin Injection With Casting in Children With Spastic Cerebral Palsy: A Randomized...

Area of Science:

• Pediatric Orthopedics
• Physical Medicine and Rehabilitation
• Neurology

Background:

• Spasticity is a common movement disorder in children with cerebral palsy (CP).
• Dynamic equinus, a spastic ankle deformity, is frequently observed in children with CP.
• Botulinum toxin (BT) injection is a recognized first-line treatment for focal spasticity.

Purpose of the Study:

• To evaluate the efficacy of botulinum toxin (BT) injection combined with casting for treating dynamic equinus in children with spastic diplegia.
• To compare the outcomes of BT injection with casting versus casting alone.

Main Methods:

• A prospective randomized controlled trial was conducted with 38 children (aged 2-12 years) diagnosed with cerebral palsy and spastic diplegia.
• Participants were divided into two groups: Group A received BT injection with casting, and Group B received casting only.
• Outcomes measured included spasticity (Modified Ashworth Scale, Modified Tardieu Scale), range of motion, and Gross Motor Function Measure (GMFM-66).

Main Results:

• Both treatment groups showed statistically significant improvements in muscle tone and passive range of motion.
• Significant differences were observed within each group for MAS and passive ROM (dorsiflexion and plantarflexion) over time.
• No statistically significant difference in MAS was found between the groups in the third week post-intervention.

Conclusions:

• Botulinum toxin injection with casting is an effective treatment for dynamic equinus in children with cerebral palsy.
• The combined approach led to significant improvements in tone and range of motion.
• Casting alone also demonstrated benefits, highlighting the importance of interventions for this condition.