Effects of Botulinum Toxin A Injection on Ambulation Capacity in Patients with Cerebral Palsy

ABSTRACT

Purpose: The purpose of the study is to assess the change in their ambulatory capacity and spasticity in children with cerebral palsy (CP) who received botulinum toxin A (BoNT-A) injection and underwent rehabilitation therapy.

Methods: Thirty patients with CP, 3–13 years who had varied functional levels and lower extremity spasticity, were randomized in two groups. In Group 1(n = 15), BoNT-A was administered to the affected extremity and underwent rehabilitation. In Group 2 (n = 15), the patients underwent only rehabilitation protocol. The Visual Analogue Scale (VAS), Tardieu Scale (TS), Gross Motor Function Classification System (GMFCS), Selective Motor Control, and Goal Attainment Scale were evaluated 4 and 12 weeks after baseline.

Results: The mean scores of the TS (p < 0.001) GMFCS, GAS, and VAS (p < 0.05) significantly improved in Group 1.

Conclusion: We think that implementation of rehabilitation protocols with BoNT-A injection is superior to alone rehabilitation therapy and increasing ambulatory capacity in patients with CP.

KEYWORDS:

• Ambulation
• botulinum toxin A
• cerebral palsy
• spasticity

Limitations

In our study, the follow-up duration of the patients was 12 weeks, the number of rehabilitation therapies was 20 sessions, and the total dose didn’t exceed 300 IU BoNT-A. Long follow-up and more rehabilitation sessions will provide a more extensive and reliable information.

Acknowledgments

We would like to thank the late Professor Kazım Şenel who helped me in recruiting study population before passing away and we want to thank our physiotherapists Eda Altun, Mehmet Sayar, and Hacer Kaya who performed physical therapy and rehabilitation protocol.

Conflict of interest

The authors report no conflict of interest. The authors alone are responsible for the content and writing of the paper.

Additional information

Funding

This study was not funded.