| Abstract | The efficacy of repeated botulinum toxin A (BTX-A) injections in two and three dose regimes, together with occupational therapy, on upper limb movement and function, was studied using an evaluator blinded, randomized, controlled two-group trial. Forty-two children (31 males, 11 females; range 2-8 y, mean 4 y [SD 1 y 7 mo]) with hemiplegic cerebral palsy (Gross Motor Function Classification System Level I) longitudinally participated for 30 months, with the first 6 months reported earlier (Lowe et al. 2006). The BTX-A group (n=21) received three injections (0, 6, and 18 mo), while the delayed group had two (6 and 18 mo; dose 0.5-2.1 units/kg, mean 1.5 [SD 0.18]; dilution 100 units/0.5 ml). At 30 months, no difference existed between groups on any standardized measures. First and second injections showed significant treatment effect sizes, on Quality of Upper Extremity Skills Test (5.5 p=0.01: 4.5 p=0.03); parent Goal Attainment Scaling (GAS; 3.5 p=0.02: 3.9 p=0.01; therapist GAS 7.8 p=0.00: 4.0 p=0.03); Canadian Occupational Performance Measure (performance 0.4 p=0.05: 0.4 p=0.02; satisfaction 0.4 p=0.05: 0.37 p=0.08); and Pediatric Evaluation of Disability Inventory functional skills (1.8 p=0.00: 2.3 p=0.04). BTX-A was not linked to adverse events, suggesting repeated upper limb injections in children with hemiplegia receiving occupational therapy were safe and effective for improvement of movement and function. |
| Authors | Kevin Lowe, Iona Novak, Anne Cusick
(Affiliation: Department of Paediatric Rehabilitation, Sydney Children's Hospital and University of New South Wales, Randwick, Australia. kev.lowe at unsw.edu.au)
|
| Journal | Developmental medicine and child neurology
(Dev Med Child Neurol)
Vol. 49
Issue 11
Pg. 823-9
(Nov 2007)
ISSN: 0012-1622 England |
| PMID | 17979860
(Publication Type: Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
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| Chemical References |
- Botulinum Toxin Type A
- Neuromuscular Agents
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| Topics |
- Botulinum Toxin Type A
(administration & dosage, adverse effects, therapeutic use)
- Cerebral Palsy
(drug therapy, physiopathology)
- Child
- Double-Blind Method
- Female
- Humans
- Injections, Intramuscular
- Male
- Neuromuscular Agents
(administration & dosage, adverse effects, therapeutic use)
- Prospective Studies
- Upper Extremity
(physiopathology)
|
