Management of Cerebral Palsy with Botulinum-A Toxin

Koman, L. Andrew; Mooney, James F.; Smith, Beth Paterson; Goodman, Amy; Mulvaney, Theresa

doi:10.1097/01241398-199307000-00013

Cited by 387 publications

(249 citation statements)

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“…The introduction of botulinum neurotoxin type-A (BoNT-A) as a treatment of spasticity in the 1990s 5 represented a major advance in the management of CP and has led to a reduced need for orthopedic surgery. 6 Clinical guidelines now recommend that BoNT-A should be offered as an effective and generally safe treatment of localized/ segmental spasticity in children and adolescents with CP.…”

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

et al. 2016

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

et al. 2016

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“…1 Chemodenervation with BoNTA has important clinical uses in the management of neuromuscular disorders including achalasia, hyperhydrosis, and spasticity and an emerging role as tendon bioprotection. [2][3][4][5][6] Although many clinicians administer BoNTA injections, little consensus exists regarding the appropriate injection dose and volume. 2,7,8 Clinical preparations for BoNTA intramuscular injection are most commonly in concentrations of 50 and 100 U/ml with an injection volume of 2-4 ml, but may be as concentrated as 500 U/ml and injected in volumes of up to 8 ml.…”

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Dose‐ and volume dependent‐response to intramuscular injection of botulinum neurotoxin‐A optimizes muscle force decrement in mice

Stone

Callahan

et al. 2011

Journal Orthopaedic Research

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Botulinum neurotoxin-A (BoNTA) is a potent neurotoxin used to alter muscle tone to manage spasticity and to provide tendon bioprotection; however, the appropriate dose and injection volume to administer is not defined. Male mice (n ¼ 120) received BoNTA injections into one gastrocnemius with either a constant volume (10 ml) with a variable dose (1, 3, 6 U/kg) or a constant dose (3 U/kg) in a variable volume (2.5, 5, 10, 20, 30 ml). Electromyographic (EMG) examination, muscle force generation (MFG), and wet muscle mass were measured in the ipsilateral and contralateral limbs at 1, 2, 4, or 12 weeks post-injection. MFG and EMG responses decreased to approximately 40% of contralateral after a 1 U/kg injection and 0% of contralateral by 3 and 6 U/kg injection at 1 week after injection. Neuromuscular blockade was greatest with a 10 ml injection volume. MFG, EMG examination, and wet muscle mass reached contralateral values 12 weeks after injection for all injection doses and volumes tested. Effective injection doses and volumes were identified for producing full and partial neuromuscular blockade in the mouse gastrocnemius. These findings have important clinical implications in the intramuscular administration of BoNTA to manage muscle tone. ß

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“…As informações encontradas no manual do GMFM incluem critérios que especificam os escores para cada item 16 . Os itens em cada dimensão são compostos por atividades sensíveis às características motoras apresentadas por crianças portadoras de PC.…”

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“…A PRS foi, inicialmente, desenvolvida por Koman et al 16 e, posteriormente, modificada por Boyd et al 17 para avaliar os resultados da aplicação da Toxina Botulínica tipo A na locomoção de indivíduos PC 3,17 (Figura 1). A PRS modificada 17 é uma escala observacional que sistematiza e quantifica a observação de componentes específicos da marcha.…”

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Efeitos do uso de órtese na mobilidade funcional de crianças com paralisia cerebral

Cury¹,

Mc²,

Melo³

et al. 2006

Rev. bras. fisioter.

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RESUMOObjetivo: Comparar o desempenho motor de crianças com paralisia cerebral (PC) em duas condições: com órtese e sem órtese. Métodos: Vinte crianças PC foram avaliadas utilizando-se o teste Gross Motor Function Measure (GMFM), a versão modificada da avaliação da marcha Physicians Rating Scale (PRS) e entrevista com os pais para avaliar o uso de órteses na rotina diária. Resultados: O teste ANOVA que foi utilizado para avaliar o efeito do uso órtese na mobilidade das crianças revelou médias significantemente superiores na condição com órtese durante o desempenho motor grosso e na marcha. Entrevistas informaram que o uso de órteses estava inserido na rotina diária e os pais demonstraram percepção positiva com relação ao uso desse dispositivo. Conclusão: As órteses promoveram o desempenho de tarefas motoras da rotina diária de crianças com PC, podendo orientar os processos de avaliação e de intervenção dos profissionais que trabalham com essa clientela.Palavras-chave: paralisia cerebral, órtese, mobilidade. ABSTRACT The Effects of the Use of Orthoses on the Functional Mobility of Children with Cerebral PalsyObjective: To compare the motor performance of children with cerebral palsy (CP) under two conditions: with and without orthoses. Method: Twenty children with CP were evaluated using the Gross Motor Function Measure test (GMFM), a modified version of the Physicians Rating Scale (PRS) locomotion assessment, and an interview with their parents to evaluate the use of orthoses in their daily routine. Results: The ANOVA test was used to evaluate the effect of orthosis use on the children's mobility, and it revealed that, when orthosis was used, the means for gross motor function and gait assessments were significantly higher. The interviews confirmed that the use of orthoses was included in the daily routine, and the parents demonstrated positive perceptions regarding the use of such devices. Conclusion: Orthoses improved the performance of routine daily motor tasks among the children with CP, and this finding may serve to guide the assessment and intervention processes of professionals who work with this clientele.

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Management of Cerebral Palsy with Botulinum-A Toxin

Cited by 387 publications

References 0 publications

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

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

Dose‐ and volume dependent‐response to intramuscular injection of botulinum neurotoxin‐A optimizes muscle force decrement in mice

Efeitos do uso de órtese na mobilidade funcional de crianças com paralisia cerebral

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