AbobotulinumtoxinA for Equinus Foot Deformity in Cerebral Palsy: A Randomized Controlled Trial

Abstract

BACKGROUND: Although botulinum toxin is a well-established treatment of focal spasticity in cerebral palsy, most trials have been small, and few have simultaneously assessed measures of muscle tone and clinical benefit.

AbobotulinumtoxinA (Dysport®) Improves Function According to Goal Attainment in Children With Dynamic Equinus Due to Cerebral Palsy

“…12 The results of these secondary and exploratory analyses of goal attainment support the overall findings and confirm that treatment with abobotulinumtoxinA improved the ability of patients to achieve their treatment goals versus placebo.…”

“…12 Institutional review boards at the participating sites approved the protocol, and the trial was executed in accordance with the Declaration of Helsinki and International Conference on Harmonization Good Clinical Practice Guidelines.…”

“…12 In this report, we focus on the impact of abobotulinumtoxinA treatment on the ability of children with dynamic foot equinus to achieve their functional goals.…”

Botulinum toxin for spasticity: a case for change to the Pharmaceutical Benefits Scheme

“…It is clear that current guidelines restrict the use of botulinum toxin, supporting intervention only for cerebral palsy and upper limb post‐stroke spasticity. For cerebral palsy, only adults who were treated as children can receive botulinum toxin, in spite of the fact that current research and clinical experience suggest that adult patients with cerebral palsy respond well to the toxin 12 . For instances of stroke, while upper limb spasticity post‐stroke can be treated (minimally), post‐stroke lower limb spasticity and foot dystonia are excluded, although the reduction of both is critical to walking 13 …”

“…For cerebral palsy, only adults who were treated as children can receive botulinum toxin, in spite of the fact that current research and clinical experience suggest that adult patients with cerebral palsy respond well to the toxin. 12 For instances of stroke, while upper limb spasticity post-stroke can be treated (minimally), post-stroke lower limb spasticity and foot dystonia are excluded, although the reduction of both is critical to walking. 13 Unfortunately, the PBS guidelines reflect outdated information about the treatment of spasticity in either the upper or lower limbs following stroke (and other neurological disorders).…”