Serial Casting vs Combined Intervention with Botulinum Toxin A and Serial Casting in the Treatment of Spastic Equinus in Children

Booth, Melissa Y.; Yates, Charlotte; Edgar, Terence S.; Bandy, William D.

doi:10.1097/01.pep.0000096382.65499.e2

Cited by 37 publications

(34 citation statements)

References 13 publications

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“…Results showed greater improvement in the ankle joint angle, and greater reduction in spasticity in the injection with casting group, which is consistent with studies conducted earlier 10,15-17…”

Section: Discussionsupporting

confidence: 90%

“…Booth et al10 compared 2 groups: 1) the first group received casting every week, 7-10 days after BTX-A injection, until the ankle dorsiflex angle was 20°, 2) the second group received casting every week until the ankle dorsiflex angle was 20°. Results showed that it took a relatively shorter amount of time for the patients in the first group to have their ankle dorsiflex angle become 20°, and their ankle joint conditions improved faster.…”

Section: Discussionmentioning

confidence: 99%

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The Effect and Complication of Botulinum Toxin Type A Injection with Serial Casting for the Treatment of Spastic Equinus Foot

et al. 2011

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ObjectiveTo identify the effect of serial casting combined with Botulinum toxin type A (BTX-A) injection on spastic equinus foot.MethodTwenty-nine children with cerebral palsy who had equinus foot were recruited from the outpatient clinic of Rehabilitation Medicine. The children were divided into 2 groups, one of which received serial casting after BTX-A injection, and the other which only received BTX-A injection. Serial casting started 3 weeks after the BTX-A injection, and was changed weekly for 3 times. Spasticity of the ankle joint was evaluated using the modified Ashworth scale (MAS), and the modified Tardieu scale (MTS). Gait pattern was measured using the physician's rating scale (PRS).ResultsThe degree of ankle dorsiflexion and the MAS improved significantly until 12 weeks following the BTX-A injection in the serial casting group (p<0.001), while the BTX-A injection-only group improved until 6 weeks following injection (p<0.05). The combined group showed a significantly greater increase in the degree of dorsiflexion compared to the BTX-A injection-only group at post-injection weeks 6 and 12 (p<0.05). Three children (11.5%) suffered from foot ulcers as a complication caused by the serial casting.ConclusionOur study demonstrated that the effect of BTX-A injection with serial casting was superior and lasted longer than the effect of BTX-A injection only in patients with spastic equinus foot. We therefore recommend BTX-A injection with serial casting for the treatment of equinus foot. However, physicians must also consider the possible complications associated with serial casting.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

The Effect and Complication of Botulinum Toxin Type A Injection with Serial Casting for the Treatment of Spastic Equinus Foot

et al. 2011

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“…The randomized controlled trials (RCTs) found no significant difference in this outcome between casting and BTX-A, 6,20 between casting plus BTX-A and casting alone, 8,18,20 or between casting plus BTX-A and BTX-A alone. 20,21 Gait parameters Children who received casting showed significantly greater improvements in stride length than children who received no casting.…”

Section: Passive Ankle Dorsiflexionmentioning

confidence: 99%

“…casting versus no treatment, casting versus BTX-A, casting plus BTX-A versus casting-only). All but one of these studies 8 were RCTs, although method of randomization was described and truly random (i.e. Jadad Scale: 1 point 26 ) in only two of these studies.…”

Section: What Is the Strength Of The Evidence?mentioning

confidence: 99%

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A systematic review of the effects of casting on equinus in children with cerebral palsy: an evidence report of the AACPDM

Blackmore

Boettcher-Hunt

Jordan

et al. 2007

Develop Med Child Neuro

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This systematic review examines the effects of casting, either alone or in combination with botulinum toxin type A (BTX‐A), on equinus in children with cerebral palsy (CP). Comparisons are made between casting alone and no treatment, between casting alone and BTX‐A alone, between combined casting and BTX‐A and each treatment by itself, and between casting followed by BTX‐A and BTX‐A followed by casting. A search of PUBMED, CINAHL, Proquest Health and Medical Complete, Cochrane Database of Systematic reviews, Physiotherapy Evidence Database (PEDro), OTseeker, Database of Reviews of Effectiveness (DARE), and Infotrieve yielded 184 citations. Articles were included in the review if they reported the effects of an intervention using casting for equinus in particpants with CP aged 20 or less, if they appeared in a peer‐reviewed scholarly journal in 1970 or later, with no language restriction, and if casting was not used in conjunction with surgery. Twenty‐two articles were selected, including seven randomized controlled trials (RCTs). There is little evidence that casting is superior to no casting, but the protocols of casting in current use have not been compared with no treatment in any RCT. There is no strong and consistent evidence that combining casting and BTX‐A is superior to using either intervention alone, or that either casting or BTX‐A is superior to the other immediately after treatment. Finally, there is no evidence that order of treatment (casting before BTX‐A versus BTX‐A before casting) affects outcome. Much of the evidence both for and against differences is weak, and results may be explained by methodological limitations. Future research needs to use adequate sample sizes, long‐term follow‐ups, and broader and more global measures.

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Botulinum toxin type A and serial casting versus botulinum toxin type A or serial casting in treating equinus gait of children with cerebral palsy

Kelly

MacKay-Lyons

Ruggles

et al. 2008

Cochrane Database of Systematic Reviews

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Serial Casting vs Combined Intervention with Botulinum Toxin A and Serial Casting in the Treatment of Spastic Equinus in Children

Abstract: Using serial casting in conjunction with BtA may achieve range of motion goals in less time than serial casting alone.

Cited by 37 publications

References 13 publications

The Effect and Complication of Botulinum Toxin Type A Injection with Serial Casting for the Treatment of Spastic Equinus Foot

The Effect and Complication of Botulinum Toxin Type A Injection with Serial Casting for the Treatment of Spastic Equinus Foot

A systematic review of the effects of casting on equinus in children with cerebral palsy: an evidence report of the AACPDM

Botulinum toxin type A and serial casting versus botulinum toxin type A or serial casting in treating equinus gait of children with cerebral palsy

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