Background.
Contracture of the triceps in the calf occurs in most CP children especially those with diplegia and
spastic hemiplegia. The purpose of our research was to evaluate the effective of TB-A in the treatment of these
contractures and the associated disturbances of the dynamic position of the foot in CP children.<br /> Material and methods. Thirty five CP children (19 with diplegia and 16 with
hemiplegia) received
botulinum toxin A (TBX-A-
Dysport) for the dynamic
contracture of the triceps surae muscle and secondary
equinovarus foot deformity. These children ranged in age from 2-11 years (mean 4.6). Previous
conservative treatment had failed to alleviate these conditions. Goniometric measurements of the passive range of motion and the evaluation of dynamie
equinovarus foot were performed prior to injection of BTX-A to 54 gastrocnemius muscles, and again at 2, 6, and 12 weeks post injection.<br /> Results. The results showed high effectiveness for TBX-A, e.g. marked reduction in equinovarity in 47 and 49 ankle joints (68%- 78%) at 2 and 6 weeks respectively, and in 19 joints (35%) at 12 weeks post-treatment, and moderate reduction in 12 (22%), 8 (15%) and 14 (26%) joints respectively. These improvements were statistically significant. In some children the positive effect was present up to 16 and 20 weeks post injection. No change was found on follow-up in 5 ankle joints (9%) at 2 weeks and in 7 (13%) at 6 and 12 weeks. Reversion to baseline scores was observed in 14 ankle joints (26%). The TB-A
therapy was cllosely integrated with physiotherapy and the use of AFO
orthosis when necessary.<br /> Conclusions.
Botulin toxin
therapy is effective in the treatment
contractures of the triceps of the calf and
equinovarus foot in children with
cerebral palsy.