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Purpose: This study evaluated the changes in gait of pediatric cerebral palsy patients after serial casting alone and serial casting in conjunction with botulinum neurotoxin treatments. Methods: Retrospective data of 31 children were investigated. Sixteen children were treated with serial casting combined with BoNT injection and 15 children were treated only with serial casting treatment. GAITRite was used to collect velocity, cadence, swing %, stance %, step length, stride length, and step time parameters to compare the outcomes of the treatments. Results: Combined treatment group unaffected side swing % showed a statistically significant difference at completion (M = 35.16 ±1.21; M = 32.46 ± 1.38; t (15) = 2.12, p = 0.049). Unaffected side stance % at pre-intervention was statistically different for serial casting only and the combined treatment groups (M = 61.69± 0.73; M = 64.88±1.20; t (14) = -2.273, p = 0.039). Pre- and post-intervention hemiplegic side swing % comparison was statistically significant for the serial casting only group (M = 40.87± 0.57; M = 42.39±0.79, t (14) = - 0.151, p = 0.032). The baseline velocity of the combined treatment group was slower than the serial casting-only group (88±11.2 vs. 107±14.4 (cm/s), p=0.007). Conclusions: This investigation suggests that for patients, who have poor ambulation quality, abnormal spatiotemporal gait parameters, and significant spasticity at pre-intervention, BoNT in conjunction with serial casting is more effective for improving ambulation quality. Serial casting can be used in conjunction with botulinum neurotoxin, which is efficient in muscle morphology and function regulation by reducing spasticity.
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Bibliogr. 30 poz., tab.
Twórcy
autor
- Acıbadem Mehmet Ali Aydınlar University, Istanbul, Turkey
- Kessler Foundation, Human Performance and Engineering Research, West Orange, New York, USA
autor
- Children’s Specialized Hospital, Mountainside, New York, USA
autor
- Kessler Foundation, Human Performance and Engineering Research, West Orange, New York, USA
autor
- Children’s Specialized Hospital, Mountainside, New York, USA
autor
- Kessler Foundation, Human Performance and Engineering Research, West Orange, New York, USA
Bibliografia
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- [24]. Schweizer M, Eylon S, Katz-Leurer M. The correlation between rhythm perception and gait characteristics at different rhythms among children with cerebral palsy and typically developing children. Gait Posture. 2020 Oct;82:83-89. doi: 10.1016/j.gaitpost.2020.08.120.
- [25]. Shoval H, Friel K, Levin J, Kim H. Cumulative Efficacy of Longitudinal Repeat Salivary Gland OnabotulinumtoxinA Injection: A Retrospective Study. Am J Phys Med Rehabil. 2021 Aug 1;100(8):798-802. doi: 10.1097/PHM.0000000000001675.
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- [28]. Wesseling M, Kainz H, Hoekstra T, Van Rossom S, Desloovere K, De Groote F, Jonkers I. Botulinum toxin injections minimally affect modelled muscle forces during gait in children with cerebral palsy. Gait Posture. 2020 Oct;82:54-60. doi: 10.1016/j.gaitpost.2020.08.122.
- [29]. Yadav S, Chand S, Majumdar R, Sud A. Effect of botulinum toxin type-A in spasticity and functional outcome of upper limbs in cerebral palsy. J Clin Orthop Trauma. 2020 Mar-Apr;11(2):208-212. doi: 10.1016/j.jcot.2020.01.002.
- [30]. Yiğitoğlu P, Kozanoğlu E. Effectiveness of electrical stimulation after administration of botulinum toxin in children with spastic diplegic cerebral palsy: A prospective, randomized clinical study. Turk J Phys Med Rehabil. 2019 Feb 4;65(1):16-23. doi: 10.5606/tftrd.2019.2236.
Uwagi
Opracowanie rekordu ze środków MNiSW, umowa nr SONP/SP/546092/2022 w ramach programu "Społeczna odpowiedzialność nauki" - moduł: Popularyzacja nauki i promocja sportu (2024).
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