Effect of a combined rehabilitation program with botulinum toxin type A injections on gross motor function scores in children with spastic cerebral palsy; a systematic review

Abstract

Cerebral palsy (CP) is primarily a disease of movement and posture. Spastic CP is the most common type of CP and is characterized by muscle spasticity. The management of CP aims to improve the function of the patients. Botulinum toxin type A (BTX-A) is one of the most effective therapies for focal spasticity for children with CP. Rehabilitation is also effective for CP when applied to children aged younger than 6 years. The study aimed to assess the effect of the combination of a rehabilitation program and BTX-A on spastic CP among children by reviewing the previous studies conducted on this subject. PubMed and Google Scholar databases were used for searching purposes to obtain articles related to the subjects of interest. The included searching terms were rehabilitation, physiotherapy, CP, children, spasticity, effect, combination, and BTX-A, which were used in several combinations to obtain all possible articles related to the current subject. A total of 340 articles were obtained; only six articles were eligible for the inclusion criteria. The six studies included 368 patients, and the longest duration of assessment was up to 13 months. The collected data from the included studies were summarized in one table. The combination of BTX-A therapy and rehabilitation for spastic CP children resulted in significant improvements in function, reduction in spasticity, improving strength compared to using BTX-A alone.