TY - JOUR
TI - Botulinum A toxin for treatment of lower limb spasticity in cerebral
palsy - Gait analysis in 49 patients
AU - Papadonikolakis, AS
AU - Vekris, MD
AU - Korompilias, AV
AU - Kostas, JP
AU - and Ristanis, SE
AU - Soucacos, PN
JO - Acta Orthopaedica Scandinavica
PY - 2003
VL - 74
TODO - 6
SP - 749-755
PB - TAYLOR & FRANCIS AS
SN - 0001-6470
TODO - 10.1080/00016470310018315
TODO - null
TODO - Background: Injection of botulinum type A toxin is a new treatment for
spasticity.
Patients and methods: We evaluated the effect of botulinum A toxin
(BTX-A) in the lower limb muscles of patients having cerebral palsy. We
tested 49 patients before and, on average, 4 (2-9) months after giving
the toxin. The evaluation included 3-dimensional computerized gait
analysis, changes in mobility level, using the Gillette Functional
Assessment Questionnaire, and gastrocnemius muscle bulk, using
ultrasonographic measurements.
Results: The patients were divided into 3 groups, according to the site
of BTX-A administration (hamstrings, gastrocnemius and multilevel).
Those who were injected in the hamstrings showed a significant
improvement in only the maximum knee extension angle during the gait
cycle. Those with spastic equinus who were injected in the gastrocnemius
muscle responded better than the other groups. The ankle angle on the
initial contact, terminal stance and preswing, maximum dorsiflexion,
ankle range of motion, per cent of single support and gait velocity
improved significantly. Overall, the patients showed significant
improvements in motor skill performance and functional health.
Interpretation: Our findings indicate that botulinum type A toxin can be
given as an adjuvant to conservative treatment of patients with cerebral
palsy.
ER -