The Impact of Botulinum Toxin Combined with Robot-Assisted Gait Training on Spasticity and Gross Motor Function on Children with Spastic Cerebral Palsy

ABSTRACT

Objective

To evaluate the impact of combining botulinum toxin-A (BoNT-A) injection with robot-assisted gait training (RAGT) on lower limb spasticity and motor function in children with cerebral palsy.

Methods

A prospective study was conducted from January 2020 to January 2023, including 68 patients. Twenty patients received the combination of BoNT-A injection and RAGT, while 48 received BoNT-A injection alone. Assessments were performed before the intervention and at 1, 3, and 6 months post-injection using the Modified Tardieu Scale (MTS), sections D and E of the Gross Motor Function Measure-88 (GMFM-88), 6-minute walk test (6MWT), and 10-meter walk test (10MWT).

Results

Compared to the control group receiving BoNT-A alone, the combination of BoNT-A and RAGT did not significantly improve spasticity-related outcomes, including MTS scores, R1, and R2 angles (p > .05). However, the combination group demonstrated significantly improved gross motor function, particularly in walking, running (GMFM-E), short-term walking endurance (6MWT), and walking speed (10MWT) in children with cerebral palsy after the intervention (p < .05).

Conclusion

While the addition of RAGT did not enhance the anti-spasticity effects of BoNT-A, it significantly improved gross motor function and walking abilities in children with cerebral palsy.

KEYWORDS:

• Botulinum toxin
• cerebral palsy
• robot-assisted gait training (RAGT)
• spasticity

Disclosure Statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This article was Funded by Medical Science and Technology Tackling Project of Henan Province (LHGJ20200426).