Effectiveness of Multilevel Botulinum Toxin A Injection with Integrated Treatment Program on Spasticity Reduction in Non-Ambulatory Young Children with Cerebral Palsy


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Aydil S., AKPINAR F. M., Akpinar E., Beng K., Yagmurlu M. F.

MEDICAL PRINCIPLES AND PRACTICE, vol.28, no.4, pp.309-314, 2019 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 28 Issue: 4
  • Publication Date: 2019
  • Doi Number: 10.1159/000499369
  • Journal Name: MEDICAL PRINCIPLES AND PRACTICE
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Page Numbers: pp.309-314
  • Istanbul University Affiliated: No

Abstract

Objective: The aim of the present study was to evaluate the effectiveness of multilevel Botulinum Toxin A (BTX-A) injection, as part of an integrated approach, for the treatment of spasticity in non-ambulatory young children with diplegic cerebral palsy (CP). Subjects and Methods: Seventeen nonambulatory patients aged 4-8 years with diplegic CP (Gross Motor Function Classification System [GMFCS] level IV) were evaluated before and at 1st, 3rd, and 6th months after BTX-A injection. The effect of BTX-A on spasticity of gastrocnemius and hamstring muscles was assessed using the Modified Ashworth Scale (MAS) and Modified Tardieu Scale (MTS). The velocity-dependent properties of spastic muscle as both slow (R2) and fast (R1) stretches were evaluated in MTS. Results: A statistically significant improvement was observed in R1 angles of gastrocnemius and hamstring muscles at 1st and 3rd months after BTX-A injection in non-ambulatory young children with CP. Statistically significant improvement was found in MAS of gastrocnemius and hamstring muscles and R2 angles of knee and ankle joint after 1st month of BTX-A injection. Conclusion: Multilevel BTX-A injection, as part of an integrated approach, can be used for focal treatment of spasticity, especially of hamstring and gastrocnemius muscles, in non-ambulatory young children with CP GMFCS level IV. (C) 2019 The Author(s) Published by S. Karger AG, Basel