Long-term effect of repeated injections of botulinum toxin in children with cerebral palsy: A prospective study

Fattal‐Valevski, Aviva; Domenievitz, Dafna; Giladi, Nir; Wientroub, Shlomo; Hayek, Shlomo

doi:10.1007/s11832-007-0075-8

Cited by 26 publications

(21 citation statements)

References 27 publications

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“…In this study, the gross motor function steadily increased up to 16 weeks after BoNT-A injection although the tone reduction at 4 weeks post-assessment was maintained until 16 weeks post-assessment. The results are in agreement with findings of previous studies in which BoNT-A intervention has a long term effect on gross motor function with intensive physical therapy after injection, although the effect of muscle tone disappeared [15][16][17][18]. However, the improvement in GMFM did not lead to improvement in spatiotemporal parameters of gait in this study.…”

Section: Discussionsupporting

confidence: 93%

Botulinum Toxin Type A Injections Impact Hamstring Muscles and Gait Parameters in Children with Flexed Knee Gait

Kim

Rha

Park

2020

Toxins

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The aim of this study was to determine if botulinum toxin type A (BoNT-A) injection into the medial hamstring can improve gait kinematics and muscle-tendon length in spastic cerebral palsy (CP) with a flexed knee gait (FKG). Twenty-nine children with spastic CP (Gross Motor Function Classification System I–III) with FKG were recruited for this prospective study. BoNT-A was injected into the semitendinosus and semimembranosus (SM) muscles under ultrasonography guidance. Assessments included Gross Motor Function Measure (GMFM), Modified Ashworth Scale (MAS), Modified Tardieu Scale (MTS), 3-dimensional computerized gait analysis, calculated SM muscle-tendon length and lengthening velocity during gait using musculoskeletal modeling at baseline, 4 and 16 weeks after the injection. Compared to baseline data, significant improvements in GMFM, MAS, and MTS were demonstrated at weeks 4 and 16, and also a significant increase in maximum knee extension during the stance phase was observed at week 4. In addition, the mean lengthening velocity during the swing phase was increased at week 16 without a change in the SM muscle length. Furthermore, there was a significant increase in anterior pelvic tilt at week 4, compared to baseline data. The significant decrease in hip internal rotation after injection was observed only in children with excessive hip internal rotation at initial contact before injection. BoNT-A injection into hamstrings leads to a significant increase in knee extension and anterior pelvic tilt with an increase in lengthening velocity of SM in spastic CP with FKG.

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Section: Discussionsupporting

confidence: 93%

Botulinum Toxin Type A Injections Impact Hamstring Muscles and Gait Parameters in Children with Flexed Knee Gait

Kim

Rha

Park

2020

Toxins

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“…29 This supports the fact that it is not due to the primary effect of botulinum toxin A on spasticity. Further study with a larger sample is needed to clarify this.…”

Section: Discussionsupporting

confidence: 58%

Upper Extremity Function and Occupational Performance in Children With Spastic Cerebral Palsy Following Lower Extremity Botulinum Toxin Injections

2010

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We studied the effect of botulinum toxin A injections to the lower extremities of spastic cerebral palsy children on upper limb body function and occupational performance. A total of 16 children with spastic cerebral palsy, aged 2 to 8 years, Gross Motor Function Classification System levels I-IV, referred to a child neurology outpatient clinic for botulinum toxin A injections to the lower limbs, underwent 4 assessments: 1 month prior to injection, immediate pre injection, and at 1 and 5 to 6 months post injection. Three tools were used to test everyday function (Canadian Occupational Performance Measure and the Pediatric Evaluation of Disability Inventory) and upper extremity body function (Quality of Upper Extremity Skills Test). Significant improvement was documented between the immediate preinjection and the 2 postinjection assessments, indicating that improvement lasted for at least 6 months. Botulinum toxin A injections to the lower extremities in children with cerebral palsy improve upper limb body function and occupational performance.

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“…After subsequent injections, the effect of the increasing range of motion was lower and insignificant [23]. Better improvement after the first injection was also observed by Linder et al [24] and Fattal-Valevski et al [25]; however, assessments of motor functions with the GMFM test showed identical improvements.…”

Section: Discussionmentioning

confidence: 73%

“…Higher and statistically significant gain was noted after the first injection in studies by Papavisilou et al [26] and Fattal-Valevski et al [25]. Also, in study by Read et al, a statistically significant gait improvement was especially marked after the first treatment and the effect was maintained also after two following treatments [27].…”

Section: Discussionmentioning

confidence: 96%

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Effectiveness of multiple botulinum toxin sessions and the duration of effects in spasticity therapy in children with cerebral palsy

et al. 2018

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Long-term effect of repeated injections of botulinum toxin in children with cerebral palsy: A prospective study

Abstract: Botulinum toxin A injections have a long-term effect on gross motor function in children with CP even though the effect on muscle tone is short-term. The effect apparently declines with repeated injections, with most children benefitting from 2 to 3 injections.

Cited by 26 publications

References 27 publications

Botulinum Toxin Type A Injections Impact Hamstring Muscles and Gait Parameters in Children with Flexed Knee Gait

Botulinum Toxin Type A Injections Impact Hamstring Muscles and Gait Parameters in Children with Flexed Knee Gait

Upper Extremity Function and Occupational Performance in Children With Spastic Cerebral Palsy Following Lower Extremity Botulinum Toxin Injections

Effectiveness of multiple botulinum toxin sessions and the duration of effects in spasticity therapy in children with cerebral palsy

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