The effect of botulinum toxin-A injection with rehabilitation for children with cerebral palsy

Abstract

Introduction: Several studies emphasize the importance of rehabilitation programs after botulinum toxin-A injection. However, no consensus can be reached concerning the content and frequency of the rehabilitation program after botulinum toxin-A. Objectives: To investigate the effectiveness of botulinum toxin-A injection and comprehensive rehabilitation treatment in children with cerebral palsy Methods: 59 children with 2-12 years who have spastic hemiplegic and diplegic CP met the following inclusion and exclusion criteria were recruited for this study. BoNT-A was injected into the spastic muscles under the guidance of musculoskeletal ultrasonography (US). After injection, the participants were randomly divided into two groups continuous (n=31) and intermittent rehabilitation (n=28), and received functional electrical stimulation for 3 months. The effects of the BoNT-A and rehabilitation have clinically assessed the muscle tone and dynamic spasticity of spastic muscles by using the MAS and MTS before and 1 and 3 months after injection. Result: Muscle tone was statistically significant (p<0.001) reduced in both groups compared to pre-treatment measurements at 1 and 3 months after treatment, using the modified Ashworth scale. When measuring muscle dynamic spasticity using the modified Tardieu scale, the angles R1 and R2 increased statistically (p<0.001) after 1 and 3 months in both groups. There was no statistically significant (p=0.175) between the two groups when comparing the results of continuous and intermittent groups. Conclusion: There were decreased muscle tone and dynamic spasticity in children with spastic cerebral palsy when BoNT-A injection with rehabilitation therapy combined. This result is independent of whether the rehabilitation treatment is continuous or intermittent.