Botulinum toxin type A in the treatment of lower limb spasticity in cerebral palsy

Ade-Hall, R.A.; Moore, Peter

doi:10.1002/14651858.cd001408

Cited by 90 publications

(70 citation statements)

References 18 publications

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“…14,15 However, no such review exists for SCI. Although studies on stroke and cerebral palsy have consistently shown that BoNT can reduce muscle tone and spasticity, its effect on functional outcomes is less certain.…”

Section: Introductionmentioning

confidence: 99%

Chemodenervation for treatment of limb spasticity following spinal cord injury: a systematic review

2015

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Study design: Systematic review. Objectives: To systematically review the literature on chemodenervation with botulinum toxin (BoNT) or phenol/alcohol for treatment of limb spasticity following spinal cord injury (SCI). Setting: British Columbia, Canada. Methods: EMBASE, MEDLINE, CINAHL, Cochrane Database of Systematic Reviews and Cochrane Central Register of Controlled Trials were searched for English language studies published up until March 2014. Studies were assessed for eligibility and quality by two independent reviewers. Results: No controlled trials were identified. A total of 19 studies were included: 9 involving BoNT and 10 involving phenol/alcohol. Owing to the clinically diverse nature of the studies, meta-analysis was deemed inappropriate. The studies produced level 4 and level 5 evidence that chemodenervation with BoNT or alcohol/phenol can lead to improvement in outcome measurements classified in the body structure and function, as well as activity domains of the International Classification of Functioning, Disability and Health framework. The Modified Ashworth Scale (MAS) was the most commonly used outcome measure. All six studies on BoNT and three of the four studies on phenol/alcohol measuring MAS reported a decrease in at least one point. An improvement in MAS was not always associated with improvement in function. The effect of phenol/alcohol has the potential to last beyond 6 months; study follow-up did not occur beyond this time point. Conclusion Chemodenervation with BoNT or phenol/alcohol may improve spasticity and function in individuals with SCI. However, there is a lack of high-quality evidence and further research is needed to confirm the efficacy of these interventions.

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Section: Introductionmentioning

confidence: 99%

Chemodenervation for treatment of limb spasticity following spinal cord injury: a systematic review

2015

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“…Botulinum Toxin A (BTA) is applied as a neuromuscular injection to treat lower limb spasticity in children with cerebral palsy (CP) [1][2][3][4][5] . The primary effect of BTA is to reduce the hyperactivity of single muscles or muscle groups through chemical denervation at the peripheral nerve ending 1,5 .…”

Section: Introductionmentioning

confidence: 99%

“…The primary effect of BTA is to reduce the hyperactivity of single muscles or muscle groups through chemical denervation at the peripheral nerve ending 1,5 . The duration of the effect is dose-dependent and subject to individual variation, lasting from two to six months 6 .…”

Section: Introductionmentioning

confidence: 99%

“…The positive effects of BTA include reduction of spasticity and this, in association with physical therapy and the use of orthoses, may lead to improvements in children's gait quality and joint range of motion 7,8 . However, increased mobility and motor skill performance are functional results that are important to such children and their families and that have not been fully explored in the literature 1,2,5 .…”

Section: Introductionmentioning

confidence: 99%

“…The aim of these criteria is to indicate the subgroup of children with CP that is most likely to show positive results following BTA injection. However, children with similar clinical characteristics and motor severity often demonstrate individual variability in functional results following application 5 . Thus, there is no consensus in the literature concerning which clinical characteristics, in pre-application evaluations, are predictive of positive functional outcomes.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Predicting mobility gains among children with cerebral palsy after application of botulinum toxin A

Cury¹,

Mc²,

Fonseca³

et al. 2009

Rev. bras. fisioter.

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Botulinum toxin type A in the treatment of lower limb spasticity in children with cerebral palsy

Blumetti

Belloti

Tamaoki

et al. 2019

Cochrane Database of Systematic Reviews

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Botulinum toxin type A in the treatment of lower limb spasticity in cerebral palsy

Cited by 90 publications

References 18 publications

Chemodenervation for treatment of limb spasticity following spinal cord injury: a systematic review

Chemodenervation for treatment of limb spasticity following spinal cord injury: a systematic review

Predicting mobility gains among children with cerebral palsy after application of botulinum toxin A

Botulinum toxin type A in the treatment of lower limb spasticity in children with cerebral palsy

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