Online citations, reference lists, and bibliographies.
← Back to Search

An Evaluation Of Botulinum-A Toxin Injections To Improve Upper Extremity Function In Children With Hemiplegic Cerebral Palsy.

D. Fehlings, M. Rang, J. Glazier, C. Steele
Published 2000 · Medicine

Cite This
Download PDF
Analyze on Scholarcy
Share
OBJECTIVE In a randomized, controlled, single-blind trial, to test the hypothesis that botulinum-A toxin (BTA) injections into the upper extremity of children with spastic hemiplegia improve upper extremity function. STUDY DESIGN Thirty children with hemiplegia, aged 2.5 to 10 years, were randomly assigned to receive: (1) a BTA injection into 1 or more of 3 muscle groups (biceps, volar forearm muscles, adductor pollicis) plus occupational therapy or (2) occupational therapy alone. Blinded outcomes obtained at baseline and at 1, 3, and 6 months included the Quality of Upper Extremity Skills Test (QUEST), goniometry measurements, grip strength, and Ashworth scores. The caregiver completed the self-care domain of the Pediatric Evaluation of Disability Inventory. RESULTS Twenty-nine subjects completed the study. The QUEST demonstrated a significant improvement favoring the treatment group on a 2-way analysis of variance (F = 4.69, df = 1,83; P =.039). BTA treatment was also associated with an improvement in score on the self-care domain of the Pediatric Evaluation of Disability Inventory (F = 4.68, df = 1,82; P =.04). CONCLUSIONS This study supports the effectiveness of BTA injections to improve upper extremity function of children with hemiplegia who have at least moderate spasticity.
This paper references
Pediatric evaluation of disability inventory (PEDI) : development, standardization and administration manual
S. Haley (1998)
10.1073/PNAS.96.6.3200
Functional repair of motor endplates after botulinum neurotoxin type A poisoning: biphasic switch of synaptic activity between nerve sprouts and their parent terminals.
A. de Paiva (1999)
10.1016/S0387-7604(98)00099-0
The role of botulinus toxin type A in treatment – with special reference to children
N. Gordon (1999)
10.1002/(SICI)1097-4598(1997)6+<181::AID-MUS13>3.0.CO;2-9
Cerebral palsy: A rational approach to a treatment protocol, and the role of botulinum toxin in treatment
B. Russman (1997)
10.1016/0021-9681(81)90073-4
The modified sphygmomanometer-an instrument to measure muscle strength: a validation study.
A. Helewa (1981)
10.1055/S-2007-979765
Botulinum toxin in the treatment of cerebral palsy.
M. Denišlič (1995)
10.1001/jama.1902.02480460047018
Text-Book of Anatomy
D. J. Cunningham (1907)
10.1093/PTJ/67.2.206
Interrater reliability of a modified Ashworth scale of muscle spasticity.
R. Bohannon (1987)
10.1080/J006V13N02_01
The Reliability and Validity of the Quality of Upper Extremity Skills Test
C. Dematteo (1993)
Occupational Therapy for Children
J. Case-Smith (1988)
10.1111/j.1469-8749.1991.tb14897.x
Neurodevelopmental Therapy and Upper‐Extremity Inhibitive Casting for Children with Cerebral Palsy
M. Law (1991)
10.1097/01241398-199405000-00005
Management of spasticity in cerebral palsy with botulinum-A toxin: report of a preliminary, randomized, double-blind trial.
L. Koman (1994)
10.1016/S1047-9651(18)30568-0
Pediatric Evaluation of Disability Inventory: Clinical Interpretation of Summary Scores Using Rasch Rating Scale Methodology
S. Haley (1993)
10.1111/j.1469-8749.1994.tb11864.x
BOTULINUM TOXIN IN THE MANAGEMENT OF THE LOWER LIMB IN CEREBRAL PALSY
A. Cosgrove (1994)
10.1016/0887-8994(94)90123-6
Botulinum toxin A in management of cerebral palsy.
R. Calderon-Gonzalez (1994)
Core textbook of anatomy
J. S. Thompson (1977)
10.1080/J006V13N04_04
Critique of the Pediatric Evaluation of Disability Inventory (PEDI)
Denise Reid (1994)
10.1056/NEJM199104253241707
Therapeutic uses of botulinum toxin.
J. Jankovic (1991)
10.1016/0007-1226(93)90203-N
Botulinum A chemodenervation: a new modality in cerebral palsied hands.
S. Wall (1993)
10.1177/154596839801200101
The Role of Electromyography in Guiding Botulinum Toxin Injections for Focal Dystonia and Spasticity
T. Ajax (1998)
Improving Upper Body Control: An Approach to Assessment and Treatment of Tonal Dysfunction
R. Boehme (1988)
10.1016/S0022-3476(05)80892-3
Prevalence of cerebral palsy among ten-year-old children in metropolitan Atlanta, 1985 through 1987.
C. Murphy (1993)
Occupational Therapy for Physical Dysfunction
C. Trombly (1977)



This paper is referenced by
SKELETAL MUSCLE ADAPTATIONS IN HAMSTRING CONTRACTURES OF CHILDREN WITH CEREBRAL PALSY
Lucas R Smith (2011)
10.1111/j.1440-1754.2008.01319.x
Effect of upper limb botulinum toxin‐A therapy on health‐related quality of life in children with hemiplegic cerebral palsy
T. Redman (2008)
10.1177/088307380201700210
Open-Label Study of Botulinum Toxin for Upper Limb Spasticity in Cerebral Palsy
V. Wong (2002)
10.1080/00207450600674525
CENTRAL EFFECT OF BOTULINUM TOXIN TYPE A IN HUMANS
D. Kim (2006)
10.1017/CBO9780511544866.010
Upper Motor Neurone Syndrome and Spasticity: Spasticity and botulinum toxin
M. Barnes (2008)
10.2340/16501977-0522
Effect of shock wave stimulation on hypertonic plantar flexor muscles in patients with cerebral palsy: a placebo-controlled study.
Ernesto Amelio (2010)
10.1212/WNL.0b013e3181cbcd2f
Practice Parameter: Pharmacologic treatment of spasticity in children and adolescents with cerebral palsy (an evidence-based review)
M. Delgado (2010)
10.1093/PTJ/86.4.573
Use of botulinum toxin type A in children with cerebral palsy.
K. W. Nolan (2006)
Use of intramuscular botulinum toxin in Malaysian children with cerebral palsy.
T. B. Khoo (2007)
Effectiveness of occupational therapy home program intervention for children with cerebral palsy : a double blind randomised controlled trial
I. Novak (2009)
The Effects of Single Event Multi-level Chemoneurolysis on Upper Extremity Function in Children with Cerebral Palsy
Seong-Woo Kim (2006)
10.1053/APMR.2003.50001
Changes in movement characteristics of the spastic upper extremity after botulinum toxin injection.
E. Hurvitz (2003)
10.1016/S0749-0712(03)00060-X
Botulinum toxin A in the management of upper limb spasticity in cerebral palsy.
Terence Y P Chin (2003)
10.1186/1471-2431-7-31
Focus on Function – a randomized controlled trial comparing two rehabilitation interventions for young children with cerebral palsy
M. Law (2007)
10.1007/PL00007815
Botulinum toxin treatment in cerebral palsy: evidence for a new treatment option
J. Kirschner (2001)
10.1111/j.1469-8749.2002.tb00772.x
Functional outcome of botulinum toxin A injections to the lower limbs in cerebral palsy
D. Reddihough (2002)
10.1111/j.1525-1403.2005.05237-1.x
Tined Lead Implantation: Results of the First 37 Implants in Maastricht
A. C. van Voskuilen (2005)
10.5694/j.1326-5377.2003.tb05082.x
In reply: Medical professionalism project
Martin B Van Der Weyden (2003)
10.1097/01202412-200511000-00001
Management of the Upper Limb in Cerebral Palsy
Terence Y. P. Chin (2005)
There was insufficient evidence to determine whether occupational therapy interventions to improve the use of the upper limb also enhanced social participation in children with cerebral palsy . Prepared by :
Claire Hyland (2006)
10.1097/01202412-200609000-00009
Optimal injection points for the neuromuscular blockade of forearm flexor muscles: a cadaveric study
C. Roberts (2006)
10.5435/00124635-200309000-00001
Botulinum neurotoxin type A.
M. Delgado (2003)
10.1186/1471-2431-12-120
Evaluation of the effects of botulinum toxin A injections when used to improve ease of care and comfort in children with cerebral palsy whom are non-ambulant: a double blind randomized controlled trial
Megan Thorley (2012)
10.1111/j.1469-8749.2007.00331.x
A randomized controlled trial comparing botulinum toxin A dosage in the upper extremity of children with spasticity
Anne Kawamura (2007)
10.1007/s11552-014-9636-8
Surgical management of the wrist in children with cerebral palsy and traumatic brain injury
L. Koman (2014)
10.1111/j.1469-8749.2004.tb00511.x
Botulinum toxin in the management of cerebral palsy
Rosalind J Jefferson Mb Bs BSc PhD Dic Mrcp Mrcpch (2007)
10.3109/11038128.2013.871059
Hand function in the play behavior of children with cerebral palsy
Luzia Iara Pfeifer (2014)
10.1111/j.1525-1403.2005.05237-8.x
Additional Effect of Botulinum Toxin A Treatment on Upper Limb Functional Skills in Children with Hemiparetic Cerebral Palsy
L. Speth (2005)
10.1053/SDER.2001.25136
Other noncosmetic uses of BOTOX.
J. Verheyden (2002)
10.1053/MDA.2001.25136
Other noncosmetic uses of BOTOX.
J. Verheyden (2001)
10.2165/00128072-200305010-00002
Spasticity Associated with Cerebral Palsy in Children
L. Koman (2003)
10.1007/BF02829820
Botulinum toxin in children with cerebral palsy
P. Singhi (2004)
See more
Semantic Scholar Logo Some data provided by SemanticScholar