An evaluation of botulinum-A toxin injections to improve upper extremity function in children with hemiplegic cerebral palsy.

Abstract

OBJECTIVE:

In a randomized, controlled, single-blind trial, to test the hypothesis that botulinum-A toxin (BTA) injections into the upper extremity of children with spastic hemiplegia improve upper extremity function.

STUDY DESIGN:

Thirty children with hemiplegia, aged 2.5 to 10 years, were randomly assigned to receive: (1) a BTA injection into 1 or more of 3 muscle groups (biceps, volar forearm muscles, adductor pollicis) plus occupational therapy or (2) occupational therapy alone. Blinded outcomes obtained at baseline and at 1, 3, and 6 months included the Quality of Upper Extremity Skills Test (QUEST), goniometry measurements, grip strength, and Ashworth scores. The caregiver completed the self-care domain of the Pediatric Evaluation of Disability Inventory.

RESULTS:

Twenty-nine subjects completed the study. The QUEST demonstrated a significant improvement favoring the treatment group on a 2-way analysis of variance (F = 4.69, df = 1,83; P =.039). BTA treatment was also associated with an improvement in score on the self-care domain of the Pediatric Evaluation of Disability Inventory (F = 4.68, df = 1,82; P =.04).

CONCLUSIONS:

This study supports the effectiveness of BTA injections to improve upper extremity function of children with hemiplegia who have at least moderate spasticity.

• Authors: D Fehlings, M Rang, J Glazier, C Steele
• Journal: The Journal of pediatrics (J Pediatr) Vol. 137 Issue 3 Pg. 331-7 (Sep 2000) ISSN: 0022-3476 [Print] United States
• PMID: 10969256 (Publication Type: Clinical Trial, Journal Article, Randomized Controlled Trial)

Chemical References

• Neuromuscular Agents
• Botulinum Toxins, Type A

Topics

• Analysis of Variance
• Arm
• Botulinum Toxins, Type A (administration & dosage)
• Cerebral Palsy (complications)
• Chi-Square Distribution
• Child
• Child, Preschool
• Evaluation Studies as Topic
• Female
• Hemiplegia (etiology, therapy)
• Humans
• Injections, Intramuscular
• Male
• Neuromuscular Agents (administration & dosage)
• Single-Blind Method
• Statistics, Nonparametric
• Treatment Outcome