Objective: To compare motor and functional performance of two groups of children with hemiplegic cerebral palsy (HCP). Only the study group (SG) received early treatment of spasticity with botulinum neurotoxin type A (BXT-A). Methods: Gross Motor Function Measure (GMFM), functional performance (Pediatric Evaluation of Disability Inventory -PEDI), range of movement, gait pattern (Physician Rating Scale -PRS) and the speed of hand movements were considered. Results: The SG, composed of 11 HCP (45.64±6.3 months), was assessed in relation to the comparison group, composed of 13 HCP (45.92±6.4 months). SG showed higher scores in four of the five GMFM dimensions, which included scores that were statistically significant for dimension B, and higher scores in five of the six areas evaluated in the PEDI. Active wrist extension, the speed of hand movements and PRS score were higher in the SG. Conclusion: Children who received early BXT-A treatment for spasticity showed higher scores in motor and functional performance.Key words: child, botulinum toxins, type A, cerebral palsy, hemiplegia.
RESUMOObjetivo: Comparar a performance motora e funcional de dois grupos de crianças com paralisia cerebral hemiplégica (PCH). Apenas o grupo de estudo (GE) recebeu tratamento precoce da espasticidade com toxina botulínica do tipo A (BXT-A). Métodos: Foram considerados a Função Motora Grossa (Gross Motor Function Measure -GMFM), performance funcional (Pediatric Evaluation of Disability Inventory -PEDI), amplitude de movimento, padrão da marcha (Physician Rating Scale -PRS) e a velocidade de movimento das mãos. Resultados: O GE, composto de 11 PCH (45,64±6,3 meses), foi analisado em relação ao grupo de comparação, composto por 13 PCH (45,92±6,4 meses). O GE mostrou maiores escores em quatro das cinco dimensões da GMFM, sendo a diferença estatisticamente significativa na dimensão B, e melhores escores em cinco das seis áreas avaliadas na PEDI. A extensão ativa do punho, a velocidade de movimento das mãos e o escore na PRS foram maiores no GE. Conclusão: As crianças que receberam tratamento precoce da espasticidade com BXT-A mostraram melhores escores motores e funcionais.Palavras-Chave: criança, toxinas botulínicas tipo A, paralisia cerebral, hemiplegia.The ultimate goal for the treatment of children with cerebral palsy (CP) is an improvement in functionality and increased independence, which will prepare these children for adult life 1 . The prognosis of a child with CP often depends on the type and severity of the palsy and the accompanying medical comorbidities 2 . In hemiplegic cerebral palsy (HCP), different severities and combinations of impairments in sensory function, perception, muscle tone, muscle strength and range of motion contribute to their motor dysfunction. Furthermore, these factors should be evaluated and managed because functionality is a component of overall health, and the appropriate combinations of interventions can improve function 3 .