Botulinum toxin type A for spastic cerebral palsy: Is it time to change praxis?

Čolović, Hristina; Dimitrijević, Ljiljana; Stanković, Ivona; Radovic-Janosevic, Dragana; Zlatanović, Dragan

doi:10.2340/16501977-2641

Cited by 1 publication

(1 citation statement)

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“…The application of botulinum toxin in the spastic musculature of the upper extremities is recommended in combination with occupational therapy. Botulinum toxin application in the case of spastic musculature of the lower extremities due to central motor neuron lesions in children with CP has undeniably proven to be effective [59][60][61]. The lack of randomized, homogenized studies is the evident reason why the recommendations are applicable only for the upper extremities, since the mechanism of spasm formation is identical in children after PS and in children with a spastic form of CP.…”

Section: Evidence-based Methodology and Rehabilitation Of Motor And F...mentioning

confidence: 99%

A Review of Current Perspectives on Motoric Insufficiency Rehabilitation following Pediatric Stroke

Colovic,

Zlatanovic,

Zivkovic

et al. 2024

Healthcare

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Pediatric stroke (PS) is an injury caused by the occlusion or rupture of a blood vessel in the central nervous system (CNS) of children, before or after birth. Hemiparesis is the most common motoric deficit associated with PS in children. Therefore, it is important to emphasize that PS is a significant challenge for rehabilitation, especially since the consequences may also appear during the child’s growth and development, reducing functional capacity. The plasticity of the child’s CNS is an important predecessor of recovery, but disruption of the neural network, specific to an immature brain, can have harmful and potentially devastating consequences. In this review, we summarize the complexity of the consequences associated with PS and the possibilities and role of modern rehabilitation. An analysis of the current literature reveals that Constraint-Induced Movement Therapy, forced-use therapy, repetitive transcranial magnetic stimulation, functional electrical stimulation and robot-assisted therapy have demonstrated at least partial improvements in motor domains related to hemiparesis or hemiplegia caused by PS, but they are supported with different levels of evidence. Due to the lack of randomized controlled studies, the optimal rehabilitation treatment is still debatable, and therefore, most recommendations are primarily based on expert consensuses, opinions and an insufficient level of evidence.

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Section: Evidence-based Methodology and Rehabilitation Of Motor And F...mentioning

confidence: 99%