Robot-mediated and clinical scales evaluation after upper limb botulinum toxin type A injection in children with hemiplegia.

Abstract

OBJECTIVE:

The aim of this pilot study was to examine changes in different aspects of impairment, including spasticity in the upper limbs, of hemiplegic children following botulinum toxin type A intervention. Progress was assessed using standard clinical measurements and a robotic device.

DESIGN:

Pre-post multiple baseline.

SUBJECTS:

Six children with hemiplegia.

METHODS:

Botulinium toxin type A injections were administered into the affected upper limb muscles. Outcomes were evaluated before and one month after the injection. Outcome assessments included: Melbourne Scale, Modified Ashworth Scale (MAS) and Passive Range of Motion. Furthermore, a robotic device was employed as an evaluation tool.

RESULTS:

Patients treated with botulinum toxin type A had significantly greater reduction in spasticity (MAS, p < 0.01), which explains an improvement in upper limb function and quality movement measured with the Melbourne Scale (p < 0.01). These improvements are consistent with robot-based evaluation results that showed statistically significant changes (p < 0.01) following botulinum toxin type A injections.

CONCLUSION:

The upper limb performs a wide variety of movements. The multi-joint nature of the task during the robot-mediated evaluation required active control of joint interaction forces. There was good correlation between clinical scales and robotic evaluation. Hence the robot-mediated assessment may be used as an additional tool to quantify the degree of motor improvement after botulinum toxin type A injections.

• Authors: Flaminia Frascarelli, Lorenzo Masia, Giuseppe Di Rosa, Maurizio Petrarca, Paolo Cappa, Enrico Castelli
• Journal: Journal of rehabilitation medicine (J Rehabil Med) Vol. 41 Issue 12 Pg. 988-94 (Nov 2009) ISSN: 1651-2081 [Electronic] Sweden
• PMID: 19841830 (Publication Type: Journal Article)

Chemical References

• Neuromuscular Agents
• Botulinum Toxins, Type A

Topics

• Adolescent
• Botulinum Toxins, Type A (administration & dosage)
• Child
• Female
• Hemiplegia (congenital, physiopathology, rehabilitation)
• Humans
• Injections, Intramuscular
• Male
• Motor Activity (physiology)
• Movement (physiology)
• Muscle Spasticity (physiopathology, rehabilitation)
• Neuromuscular Agents (administration & dosage)
• Outcome Assessment, Health Care
• Pilot Projects
• Recovery of Function
• Robotics
• Treatment Outcome
• Upper Extremity (physiopathology)