Related Experiment Video
Updated: Jan 8, 2026
Author Spotlight: Repetitive Transcranial Magnetic Stimulation Combined with Movement Observation in Cerebral Palsy
Published on: August 9, 2024
Effect of Botulinum Toxin Injection in Hip Adductor Muscles on Gross Motor Function in Low-Functioning Children with
Jun Min Cha1, Jehyun Yoo1, Juntaek Hong1
1Department and Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul, Korea.
Insights
Botulinum toxin type A (BoNT-A) injections improved gross motor function in children with low-functioning cerebral palsy (CP) across GMFCS levels III-V. Improvements were seen in overall function and specific domains, regardless of injection site.
Area of Science:
- Pediatric Neurology
- Rehabilitation Medicine
- Movement Disorders
Background:
- Cerebral palsy (CP) significantly impacts gross motor function in children.
- Low-functioning CP (GMFCS levels III-V) presents unique challenges in managing spasticity, particularly in hip adductor muscles.
- Botulinum toxin type A (BoNT-A) is a common treatment for spasticity, but its effect on gross motor function in severe CP requires further investigation.
Purpose of the Study:
- To evaluate the effectiveness of BoNT-A injections in improving gross motor function in children with low-functioning CP (GMFCS levels III-V).
- To assess the impact of BoNT-A on specific functional domains and different injection site combinations.
Main Methods:
- Retrospective study of 100 preschool children with CP (GMFCS III-V) receiving adductor BoNT-A injections.
- Gross Motor Function Measure (GMFM) assessed pre- and post-injection (3 weeks to 4 months).
- Statistical comparison using Wilcoxon signed-rank test, with subgroup analyses by GMFCS level and injection site.
Main Results:
- Significant GMFM score improvements observed across all GMFCS levels (p<0.05).
- Children at GMFCS III and IV showed gains in all domains (A-E); GMFCS V showed gains in domains A, B, and C (p<0.05).
- Significant improvements noted for adductor-only, adductor-hamstring, and adductor-distal muscle injections (p<0.05).
Conclusions:
- BoNT-A injections targeting hip adductor muscles effectively improve gross motor function in children with low-functioning CP.
- Functional improvements span overall and specific domains, irrespective of whether injections target adductors alone or in combination with other muscle groups.
Purpose:
Botulinum toxin type A (BoNT-A) injections are used to manage spasticity in children with low-functioning cerebral palsy (CP), particularly in cases involving the hip adductor muscles. Despite their widespread use, research on the impact of BoNT-A injections on gross motor function in children with CP within Gross Motor Function Classification System (GMFCS) levels III-V remains limited, prompting us to evaluate their effectiveness in this population.
Materials And Methods:
This retrospective study included 100 preschool children (mean age, 3.9 years) with CP (GMFCS levels III-V) who received BoNT-A injections targeting the adductor muscles at a tertiary hospital (2006-2024). Gross motor function was assessed using the Gross Motor Function Measure (GMFM) within 1 month before injection and between 3 weeks and 4 months post-injection. Subgroup analyses were conducted by GMFCS level and by injection site. Pre- and post-injection assessments were compared using the Wilcoxon signed-rank test.
Results:
GMFM scores improved significantly across all GMFCS levels (p<0.05). Children at GMFCS levels III and IV demonstrated improvements across all domains (A-E), whereas those at GMFCS level V showed significant gains in domains A, B, and C (p<0.05). Further analyses showed significant improvements in all three groups: adductors alone, adductors and hamstrings, and adductors and distal muscles (p<0.05).
Conclusion:
BoNT-A injections into hip adductor muscles improved gross motor function in children with low-functioning CP, affecting both overall and specific functional domains. This effect was observed in children who received injections into the adductors alone, as well as in combination with injections into the hamstrings or distal muscles.
More Related Videos
Related Concept Videos
01:26Directly Acting Muscle Relaxants: Dantrolene and Botulinum Toxin
The binding of dantrolene to the RYR1...
01:31Skeletal Muscle Relaxants: Therapeutic Uses