Efficacy of Repeat AbobotulinumtoxinA (Dysport®) Injections in Improving Gait in Children with Spastic Cerebral Palsy

Dursun, Nigar; Bonikowski, Marcin; Dabrowski, Edward; Matthews, Dennis J.; Gormley, Mark E.; Tilton, Ann; Carranza, Jorge; Grandoulier, Anne-Sophie; Picaut, Philippe; Delgado, Mauricio R.

doi:10.1080/17518423.2019.1687602

Cited by 11 publications

(9 citation statements)

References 25 publications

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“…Functional efficacy of BoNT-A on treatment goals and gait function of ambulatory children with CP presenting with equinus foot deformity were revealed by repeat aboBoNT-A injections to relevant lower limb muscles in a large international trial by the Goal Attainment Scale (GAS) and Observational Gait Scale (OGS). 24 25 Sahoo et al reported that children with CP having GMFCS levels of III to V had lower scores in CASP questionnaire in all areas of participation to daily life compared with children with GMFCS levels I and II. 26 Aiming to show the impact of improvement in muscle tone and spasticity on activity, and participation domains of ICF, CPCHILD, and CASP questionnaires were used in this study.…”

Section: Discussionmentioning

confidence: 99%

Improved Sitting Balance in Children with Cerebral Palsy: Body Functions to Activity and Participation

Akyuz¹,

Dursun

Gokbel

et al. 2022

Journal of Pediatric Neurology

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The aim of this study is to evaluate the changes in activity and participation domains of International Classification of Functioning (ICF), Disability and Health, in children with cerebral palsy (CP) who received integrated botulinum toxin A (BoNT-A) treatment with intensive rehabilitation with a treatment goal of improved sitting balance. In this prospective observational study, 29 patients with CP (mean age: 6.7 ± 3.8 years) and the Gross Motor Function Classification System (GMFCS) levels of IV and V were included. The primary outcome measures were the mean changes from baseline to posttreatment weeks 10 to 12 of the Child and Adolescent Scale of Participation (CASP) and Caregiver Priorities and Child Health Index of Life with Disabilities (CPCHILD). The modified Ashworth scale (MAS) and Tardieu scale (TS) results at 6 to 8 weeks of posttreatment were the secondary outcome measures. Statistically significant improvements in home and community participation of CASP (p < 0.001 and 0.001), CPCHILD (p < 0.01), MAS (p < 0.001), and all parameters of TS (p < 0.05) were recorded after treatment. The result of this prospective, observational study showed that the functional improvements in sitting balance by the integrated BoNT-A treatment provides positive effects on activity and participation levels of the patient and quality of life of patients and their families.

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Section: Discussionmentioning

confidence: 99%

Improved Sitting Balance in Children with Cerebral Palsy: Body Functions to Activity and Participation

Akyuz¹,

Dursun

Gokbel

et al. 2022

Journal of Pediatric Neurology

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“…Significantly higher decreases of muscle hypertonia and spasticity (MAS, MTS), goal achievement (GAS), and overall global clinical impression (PGA) were demonstrated for the treatment groups [22,40,41]. In the double-blind phase, AboBoNT-A significantly improved observational gait scale (OGS) total scores versus placebo at week 4, and continued to improve gait throughout the OL phase [42]. Importantly, a long-term therapeutic effect was demonstrated: 74% of children treated did not require retreatment before week 16 or later, with 17.7% of patients not requiring retreatment before week 28 [40].…”

Section: E a D I N G T O P I Cmentioning

confidence: 99%

Safety and efficacy of Botulinum toxin type A preparations in cerebral palsy — an evidence-based review

Bonikowski¹,

Sławek²

2021

Neurol Neurochir Pol.

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The introduction of botulinum toxin more than 25 years ago for the management of paediatric lower and upper limb hypertonia has been a major advance. BoNT-A as a part of multimodal treatment supports motor development and improves function disturbed by spasticity or hypertonia.The aim of this paper was to compare the efficacy and safety of three major BoNT-A preparations present on the market: abo-, inco-, and onaobotulinumtoxinA in the treatment of children with cerebral palsy. Based on an analysis of the available literature, all three preparations have been established to reduce hypertonia in the upper and lower extremities, with some conflicting evidence regarding function. There were no differences in treatment safety, with a low incidence of adverse events which were mostly temporary and mild. Any form of universal conversion ratio between all preparations is not recommended.

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“…Strikingly, in most of the previous studies only the BoNT-A part was put forward as the effective component, thus disregarding the (potential) contribution of the modalities from the comprehensive rehabilitation part, such as physiotherapy, casting and orthosis (e.g. (5,6,(20)(21)(22)(23)(24) (Fig. 1b).…”

Section: Interpretation and Presentation Of Previous Researchmentioning

confidence: 99%

The role of botulinum toxin in multimodal treatment of spasticity in ambulatory children with spastic Cerebral Palsy: extensive evaluation of a cost-effectiveness trial

Bussmann¹,

Pangalila²,

Stam³

et al. 2020

J Rehabil Med

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Recently, we performed a study on the added value of botulinum toxin injections (BoNT-A) for ambulatory children with spastic cerebral palsy (the Space Bop study). The results showed that BoNT-A did not add any value in this context, but this counterintuitive finding was met with scepticism. The aim of this paper is to describe and discuss some crucial aspects of, and barriers to, the Space Bop study. The paper also discusses the design, interpretation and presentation of previous research; the role of clinician's own experience and interpretation; the aims of (BoNT-A) treatment; conflict of interest, role of industry, and the role of history; and optimal treatment modalities and dose-response relationships. We conclude that several factors hindered acceptance of the Space Bop results. Awareness of these factors is important when performing rehabilitation research and disseminating and implementing research findings. Background: A cost-effectiveness trial (the Space Bop study) on the added value of botulinum toxin injections (BoNT-A) in the leg muscles, as part of a multimodal intervention for ambulatory children with spastic cerebral palsy in the context of a single distinct cycle of care was performed recently by our group. For a broad set of effect outcomes, we found that BoNT-A had no added value if children received comprehensive rehabilitation. However, this counterintuitive finding was met with scepticism. Objective: Since several noteworthy facts and experiences were recorded during the course of the trial and the dissemination phase, the aim of this paper was to describe and discuss some crucial aspects of, and barriers to, the Space Bop study, related to context and perspective, design and results, as well as publication and implementation. Methods: This paper discusses 5 issues: (i) the design, interpretation and presentation of previous research; (ii) the role of one's own clinical experience and interpretation; (iii) the aims of (BoNT-A) treatment; (iv) conflict of interest, role of industry, and the role of history; (v) optimal treatment modalities and dose-response relationships. Conclusion: Despite the unambiguous findings from the Space Bop study, several factors hindered acceptance of the results. Awareness of these factors is important when performing rehabilitation research and disseminating and implementing research findings.

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Efficacy of Repeat AbobotulinumtoxinA (Dysport®) Injections in Improving Gait in Children with Spastic Cerebral Palsy

Cited by 11 publications

References 25 publications

Improved Sitting Balance in Children with Cerebral Palsy: Body Functions to Activity and Participation

Improved Sitting Balance in Children with Cerebral Palsy: Body Functions to Activity and Participation

Safety and efficacy of Botulinum toxin type A preparations in cerebral palsy — an evidence-based review

The role of botulinum toxin in multimodal treatment of spasticity in ambulatory children with spastic Cerebral Palsy: extensive evaluation of a cost-effectiveness trial

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