Abstract | OBJECTIVE: To measure the effect of intensive therapy and the lasting effect of a standardized functional training programme with vs. without the addition of chemodernervation of the muscles of the forearm and hand. PATIENTS AND METHODS: Twenty children with spastic hemiplegia, aged 4-16 years, were matched for baseline characteristics and randomized to standardized task-oriented therapy for 6 months with or without botulinum toxin injections. Dynamic kinematic outcome measures were: speed, accuracy, end-point spread and performance. Measurements of active and passive range of motion, stretch-restricted angle of the elbow and wrist, Ashworth scores and Melbourne Assessment of Unilateral Upper Limb Function were made. All measures were performed at baseline, 2 weeks after injection of botulinum toxin and after 6 months (at the end of therapy), and 3 months after end of the therapy. RESULTS: Clinical measures showed improvement in both groups. However, no significant differences emerged between groups on functional measures. Directly after the botulinum toxin injection all kinematic outcome measures showed a decrease, but baseline values were re-established during the therapy period. After botulinum toxin injections a temporarily significant greater increase in speed and performance was found. These results illustrate the need for further quantitative research into the effects of botulinum toxin.
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Authors | Eugene A A Rameckers, Jacques Duysens, Lucianne A W M Speth, Hans J S Vles, Bouwien C M Smits-Engelsman |
Journal | Journal of rehabilitation medicine
(J Rehabil Med)
Vol. 42
Issue 4
Pg. 332-8
(Apr 2010)
ISSN: 1651-2081 [Electronic] Sweden |
PMID | 20461335
(Publication Type: Journal Article, Randomized Controlled Trial)
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Chemical References |
- Neuromuscular Agents
- Botulinum Toxins, Type A
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Topics |
- Activities of Daily Living
- Adolescent
- Botulinum Toxins, Type A
(therapeutic use)
- Cerebral Palsy
(drug therapy, physiopathology, rehabilitation)
- Child
- Child, Preschool
- Follow-Up Studies
- Hemiplegia
(drug therapy, physiopathology, rehabilitation)
- Humans
- Motor Skills
- Neuromuscular Agents
(therapeutic use)
- Outcome Assessment, Health Care
- Range of Motion, Articular
(physiology)
- Task Performance and Analysis
- Treatment Outcome
- Upper Extremity
(physiopathology)
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