The effects of botulinum toxin type A on improvement and dynamic spastic equinus correction in children with cerebral palsy - preliminary results

Hristina Colovic; Lidija Dimitrijevic; Ivona Stankovic; Dejan Nikolic; Dragana Radovic-Janosevic; Dragoljub Zivanovic

doi:10.5114/aoms.2014.46217

The effects of botulinum toxin type A on improvement and dynamic spastic equinus correction in children with cerebral palsy - preliminary results

Arch Med Sci. 2014 Oct 27;10(5):979-84. doi: 10.5114/aoms.2014.46217. Epub 2014 Oct 23.

Authors

Hristina Colovic¹, Lidija Dimitrijevic², Ivona Stankovic², Dejan Nikolic³, Dragana Radovic-Janosevic⁴, Dragoljub Zivanovic⁵

Affiliations

¹ Clinic for Physical Therapy and Rehabilitation, Clinical Centre of Nis, Nis, Serbia.
² Clinic for Physical Therapy and Rehabilitation, Clinical Centre of Nis, Nis, Serbia ; Faculty of Medicine, University of Nis, Nis, Serbia.
³ Physical Medicine and Rehabilitation, University Children's Hospital, Belgrade, Serbia.
⁴ Faculty of Medicine, University of Nis, Nis, Serbia ; Gynecology and Obstetrics Clinic, Clinical Centre of Nis, Nis, Serbia.
⁵ Faculty of Medicine, University of Nis, Nis, Serbia ; Pediatric Surgery Clinic, Clinical Centre of Nis, Nis, Serbia.

Abstract

Introduction: We evaluated the effects of botulinum toxin type A (BTA) with physical therapy on dynamic foot equinus correction and higher motor functional outcome in children with spastic type of cerebral palsy (CP).

Material and methods: Ankle joint active and passive movement, gastrocnemial muscle spasticity levels (Modified Ashworth Scale (MAS)), and higher motor functional status (Gross Motor Function Classification System (GMFCS) and Gross Motor Function Measure (GMFM) (GMFM-D - standing and GMFM-E - walking) were assessed before treatment and 3, 8, 16 weeks and 6 months after BTA administration in 12 children.

Results: There was a significant improvement of active (initial - (-)13.07 ±5.78; 6 months - (-)10.64 ±4.77; p < 0.001) and passive (initial - 4.21 ±2.29; 6 months - 4.71 ±2.16; p < 0.05) ankle joint foot dorsiflexion. GMFM-D and GMFM-E were significantly higher after 3, 8, 16 weeks (p < 0.001) and GMFM-D after 6 months (p < 0.001).

Conclusions: Botulinum toxin type A administration and physical therapy in patients with spastic CP improves the motion range of dynamic foot equinus after 3 weeks and higher motor functional outcome (standing and walking).

Keywords: botulinum toxin; cerebral palsy; dynamic equines.