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Biomechanical Transformation Of The Gastroc‐soleus Muscle With Botulinum Toxin A In Children With Cerebral Palsy
R. Boyd, V. Pliatsios, R. Starr, R. Wolfe, H. Graham
Published 2000 · Medicine
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Objective measures (kinematics and kinetics) were used to study prospectively the effects of botulinum toxin A (BTX/A) on the gastroc‐soleus muscle in ambulant children with cerebral palsy. In this prospective before and after trial, 15 children with diplegia and 10 children with hemiplegia were studied (mean age 5 years 7 months, range 4 years to 9 years). A range of standardized clinical measures was undertaken but the emphasis for this report is on the three‐dimensional gait analysis (3DGA) results. All children showed improvements in sagittal ankle kinematics, as has been previously reported. Two new measures of ankle kinetics were devised: ankle moment quotient (AMQ), and ankle power quotient (APQ). Before intervention, ankle moments were characterized by a‘double bump’ankle moment. A typical abnormal baseline ankle‐power curve was triphasic with an initial trough of absorption followed by abnormal mid‐stance power generation, instead of the usual A1 pattern, and reduced terminal stance power generation (A2). Three weeks after treatment with BTX/A alone there was a statistically significant improvement of AMQ and APQ; some patients required potentiation of BTX/A with a short period of serial casts. Both groups (BTX/A alone and BTX/A plus casting) continued to show improvement in ankle kinetics from baseline after 12 and 24 weeks. This is the first study to demonstrate improvements in the typical abnormal ankle kinetics which we believe provides evidence of the ‘biomechanical transformation of muscle’.
This paper references
Pharmacologic characterization of botulinum toxin for basic science and medicine.
L. Pearce (1997)
Botulinum toxin A compared with stretching casts in the treatment of spastic equinus: a randomised prospective trial.
I. Corry (1998)
‘Botulinum toxin treatment in cerebral palsy: intervention with poor evaluation?
L J. Areus (1998)
The analysis of longitudinal data
P. Diggle (1995)
Medium‐term response characterisation and risk factor analysis of botulinum toxin type A in the management of spasticity in children with cerebral palsy
R. Boyd (1999)
Double-blind study of botulinum A toxin injections into the gastrocnemius muscle in patients with cerebral palsy.
D. Sutherland (1999)
Clues to the multi-phasic inhibitory action of botulinum neurotoxins on release of transmitters.
J. Dolly (1990)
Medium term outcomes and risk factor analysis of botulinum toxin A in the management of spasticity in children with cerebral palsy
J — Graham (1999)
A gait analysis data collection and reduction technique
R. B. Davis (1991)
Botulinum toxin A in the management of children with cerebral palsy: indications and outcome
R. Boyd (1997)
BOTUNUM TOXIN A PREVENTS THE DEVELOPMENT OF CONTRACTURES IN THE HEREDITARY SPASTC MOUSE
A. Cosgrove (1994)
Botulinum toxin A in hamstring spasticity.
I. Corry (1999)
A PROSPECTIVE STUDY OF INHIBITIVE CASTING AS AN ADJUNCT TO PHYSIOTHERAPY FOR CEREBRAL‐PALSIED CHILDREN
J. Watt (1986)
Botulinum Toxin A in the Hemiplegic Upper Limb: A Double‐blind Trial
L. Arens (1997)
Daniel's and Worthingham's muscle testing : techniques of manual examination
H. Hislop (1995)
Botulinum toxin A in the hemiplegia upper limb: a double‐blind trial
I. S. Corry (1997)
Is the double bump ankle moment pattern caused by spasticity
R. Pierce (1997)
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)
A la recherche d ’ une technique de mesure de la spasticité . Imprime avec le periodique
J Watt (1954)
Pharmocologic characterisation of Botulinum toxin for basic science and medicine
LB Pearce (1997)
Interrater reliability of a modified Ashworth scale of muscle spasticity.
Richard W. Bohannon (1987)
Kinematic and Kinetic Evaluation of the Ankle After Lengthening of the Gastrocnemius Fascia in Children with Cerebral Palsy
S. Rose (1993)
Botulinum toxin A prevents the development of contractures in the hereditary spastic mouse.
A. Cosgrove (1994)
Gait characterization via dynamic joint stiffness
R. Davis (1996)
Acceptors for botulinum neurotoxin reside on motor nerve terminals and mediate its internalization
J. O. Dolly (1984)
Management of spasticity in cerebral palsy with botulinum-A toxin: report of a preliminary, randomized, double-blind trial.
L. Koman (1994)
Injection of botulinum toxin A into the gastrocnemius muscle of patients with cerebral palsy: a 3-D motion analysis study
DH Sutherland (1996)
BOTULINUM TOXIN IN THE MANAGEMENT OF THE LOWER LIMB IN CEREBRAL PALSY
A. Cosgrove (1994)
Principles of Dynamics
L. Howarth (1964)
Extrafusal and intrafusal muscle effects in experimental botulinum toxin‐A injection
R. Rosales (1996)
A la recherche d'une technique de mesure de la spasticité.
G. Tardieu (1954)
Management of Cerebral Palsy with Botulinum‐A Toxin: Preliminary Investigation
L. Koman (1993)
Correlates of leukoaraiosis and ventricular enlargement on magnetic resonance imaging: a study in normal elderly and cerebrovascular patients
A. Padovani (1997)
Botulinum A toxin effects on rat jaw muscle spindles.
G. Filippi (1993)
The effects of botulinum toxin on the pattern of innervation of skeletal muscle in the mouse.
L. Duchen (1968)
The action of botulinum toxin on the neuro‐muscular junction
A. Burgen (1949)
Voluntary (normal) versus obligatory (cerebral palsy) toe-walking in children: a kinematic, kinetic, and electromyographic analysis.
J. Davids (1999)
Voluntary (normal) versus obligatory (cerebral palsy) toe walking in children: a kinematic, kinetic and EMG analysis
JR Davids (1999)
Clinical Gait Analysis in Cerebral Palsy
J R Gage (1994)
Gait Analysis in Cerebral Palsy, Clinics in Developmental Medicine No. 121
J. Davids (1993)
Transient urinary incontinence after botulinum A toxin
R. Boyd (1996)
Botulinum toxin treatment in cerebral palsy: intervention with poor evaluation?
H. Forssberg (1997)
Injection of botulinum A toxin into the gastrocnemius muscle of patients with cerebral palsy: a 3-dimensional motion analysis study
D. Sutherland (1996)
Gait Analysis, Normal and Pathological Function.
S. Simon (1993)
Rules of evidence and clinical recommendations on the use of antithrombotic agents.
D. Sackett (1986)
This paper is referenced by
Literature Review and Comparison of Two Statistical Methods to Evaluate the Effect of Botulinum Toxin Treatment on Gait in Children with Cerebral Palsy
A. Nieuwenhuys (2016)
Botulinum Toxin Type A Injection for Spastic Equinovarus Foot in Children with Spastic Cerebral Palsy: Effects on Gait and Foot Pressure Distribution
J. Y. Choi (2016)
Status of the Instrumented Gait Analysis and its Role in Rehabilitation Medicine
M. Ohashi (2001)
Functional outcome of botulinum toxin A injections to the lower limbs in cerebral palsy
D. Reddihough (2002)
[The author of the year].
S. Dobrić (2007)
Botulinum Toxin Type A in Ambulant Children with Cerebral Palsy
A. Mackey (2003)
Validation of a visual gait assessment scale for children with hemiplegic cerebral palsy.
Wendy E Dickens (2006)
Botulinum toxin injections minimally affect modelled muscle forces during gait in children with cerebral palsy.
M. Wesseling (2020)
Injectable Neuromuscular Blockade in the Treatment of Spasticity and Movement Disorders
A. Tilton (2003)
Comparing botulinum toxin A with casting for treatment of dynamic equinus in children with cerebral palsy
J. Ackman (2005)
Computerized gait analysis of Botulinum Toxin treatment in children with cerebral palsy
M. Galli (2007)
Kinematic features of the foot in the transverse plane extracted from 26 papers , identified through systematic literature
J. Ackman (2016)
A combination of Botulinum Toxin A therapy and Functional Electrical Stimulation in children with cerebral palsy--a pilot study.
S. Galen (2012)
Botulinum toxin treatment of spasticity in diplegic cerebral palsy: a randomized, double‐blind, placebo‐controlled, dose‐ranging study
R. Baker (2002)
Decision-Making for Neurosurgical Treatment of Disabling Spasticity in Adults
M. Sindou (2004)
[Does footprint and foot progression matter for ankle power generation in spastic hemiplegic cerebral palsy?].
J. Riad (2009)
Botulinum toxin with and without casting in ambulant children with spastic diplegia: a clinical and functional assessment
M. Bottos (2003)
Botulinum toxin in the management of cerebral palsy
R. Jefferson (2004)
Pedobarometric evaluation of equinus foot disorder after injection of botulinum toxin A in children with cerebral palsy: A pilot study
M. Falso (2005)
Effectiveness of botulinum toxin A for upper and lower limb spasticity in children with cerebral palsy: a summary of evidence
M. Lukban (2008)
肉毒桿菌毒素對中風患者偏癱上肢之協同反應及偏癱性步態的療效評估; Therapeutic effectiveness of botulinum toxin on associated reactions of the upper limbs and hemiplegic gait in stroke patients
Are gait and mobility measures responsive to change following botulinum toxin injections in adults with lower limb spasticity?
J. Chan (2013)
The emerging role of therapeutic botulinum toxin in the treatment of cerebral palsy.
F. Pidcock (2004)
Spasticity in adults: management using botulinum toxin: National Guidelines.
S. Ashford (2009)
AACPDM systematic review of the effectiveness of therapy for children with cerebral palsy after botulinum toxin A injections
Natasha Lannin AccOT BSc GradDip (2006)
The neuronal group selection theory: promising principles for understanding and treating developmental motor disorders
M. Hadders-Algra (2000)
Effect of lower-limb torsional deformities on muscle and joint function during gait
E. Passmore (2017)
Can persistent drop foot after calf muscle lengthening be predicted preoperatively?
B. Lofterød (2009)
Recent Advances: Orthopaedics.
C. Moran (2001)
Botulinum Toxin A Injections in Children: Technique and Dosing Issues
D. Kinnett (2004)
Chapter 14 – Treatment of Motor Disorders in Cerebral Palsy with Botulinum Neurotoxin
J. Leonard (2009)
Improvement of gait pattern for children with infantile cerebral palsy and dynamic pes equinus after treatment with hinged subtalar circular locking ankle foot-orthoses
V. Metzler (2008)See more