Parent Evaluation of Spasticity Treatment in Cerebral Palsy Using Botulinum Toxin Type A

Symons, Frank J.; Rivard, Patrick; Nugent, Andrea C.; Tervo, Raymond C.

doi:10.1016/j.apmr.2006.08.343

Cited by 19 publications

(7 citation statements)

References 10 publications

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“…Children undergoing BoNT‐A injections for spasticity often receive multiple intramuscular injections at regular intervals 20 . A recent report from our institution indicated that parents are concerned about the pain associated with the procedure but find that the benefits of BoNT‐A injections outweigh this concern 21 . Pain with injection, however, has been cited as a reason for discontinuation of BoNT‐A injections in children 22 …”

Section: Resultsmentioning

confidence: 99%

Effectiveness of sedation using nitrous oxide compared with enteral midazolam for botulinum toxin A injections in children

Zier

Rivard²,

Krach

et al. 2008

Develop Med Child Neuro

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This randomized, double-blind, placebo-controlled study compared the efficacy of inhaled nitrous oxide (N 2 O) with enteral midazolam for sedation of children with cerebral palsy (CP) undergoing botulinum toxin A (BoNT-A) injections. Fifty children (29 males, 21 females; mean age 8y 2mo [SD 4y 5mo]; range 1-16y) were randomized to sedation with N 2 O (n=25) or midazolam (n=25). Groups were similar in type of

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Section: Resultsmentioning

confidence: 99%

Effectiveness of sedation using nitrous oxide compared with enteral midazolam for botulinum toxin A injections in children

Zier

Rivard²,

Krach

et al. 2008

Develop Med Child Neuro

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“…The healthcare needs of adults with ID have not been well studied, while children with similar problems garner greater academic attention 9, 27–29. The reason for this disparate interest is not entirely clear.…”

Section: Discussionmentioning

confidence: 99%

Spasticity treatment facilitates direct care delivery for adults with profound intellectual disability

Charles

Gill

Taylor³

et al. 2010

Movement Disorders

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Many adults with intellectual disabilities (ID) have spasticity, where increased muscle tone impairs activities of daily living (ADL) self-performance and care delivery. There are few reports of spasticity treatment for people with ID, and none of functionally meaningful outcomes. Our objective is to determine the effect of comprehensive spasticity management on ADL self-performance and care delivery. Baseline evaluation included repeated modified Ashworth and range of motion assessments, and timed and videotaped care task observations. Spasticity treatment was initiated immediately thereafter. Follow-up evaluation was conducted after spasticity management was optimized, one year after initiation. All individuals with spasticity at a single developmental center for whom treatment goals could be identified were included. Treatment was recommended by a neurologist from any accepted treatment for spasticity except oral medications, including botulinum neurotoxin A, intrathecal baclofen and orthopedic procedures. The main outcome measure is comparison of ease of videotaped care delivery, rated by direct caregivers blinded to participant treatment status. Spasticity treatment resulted in significant improvement across all outcome measures. Range of motion improved by 9 degrees (P = 0.005) and MAS by 0.4 (P = 0.022). Participants took 14% percent less time to complete tasks post-treatment (P = 0.01). Thirteen caregivers completed evaluations of 35 video pairs with an intra-class correlation of 0.9. After treatment, undergarment change (P = 0.031) and shirt change (P = 0.017) were rated easier, and all goals (P = 0.0006). Transfers trended toward improvement (P = 0.053). This study shows comprehensive spasticity management provides meaningful improvement in ADL care for patients with ID, which may improve quality of life and reduce caregiver burden.

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“…The experiences of families were only gathered from nine parents who were all mothers. It is possible that the experiences of fathers or other carers such as grandparents or foster carers may differ, as other studies have suggested (Symons, Rivard, Nugent, & Tervo, 2006). Similarly, no families who had low levels of English or who had terminated BoNT-A treatments were interviewed; future studies with these populations are needed.…”

Section: Supportmentioning

confidence: 99%

Using family and staff experiences of a botulinum toxin‐A service to improve service quality

Burton

Bau

Lewis

et al. 2017

Child

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Areas of importance identified by families relating to BoNT-A treatment included acknowledgement of individual needs, care coordination, empowerment of families and patients, consistency in service delivery, and the distressing nature of appointment and decision-making. Comparison of the data from the staff patient journey mapping and family interviews suggested that staff have a good but incomplete understanding of the factors important to families, highlighting the need for consumer engagement in establishing family-centred care. The themes identified can guide the provision of family-centred BoNT-A injection clinics.

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Parent Evaluation of Spasticity Treatment in Cerebral Palsy Using Botulinum Toxin Type A

Cited by 19 publications

References 10 publications

Effectiveness of sedation using nitrous oxide compared with enteral midazolam for botulinum toxin A injections in children

Effectiveness of sedation using nitrous oxide compared with enteral midazolam for botulinum toxin A injections in children

Spasticity treatment facilitates direct care delivery for adults with profound intellectual disability

Using family and staff experiences of a botulinum toxin‐A service to improve service quality

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