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J Pediatr. 2000 Sep;137(3):331-7.

An evaluation of botulinum-A toxin injections to improve upper extremity function in children with hemiplegic cerebral palsy.

Author information

1
Division of Neurology, Bloorview MacMillan Centre, Toronto, Ontario, Canada.

Abstract

OBJECTIVE:

In a randomized, controlled, single-blind trial, to test the hypothesis that botulinum-A toxin (BTA) injections into the upper extremity of children with spastic hemiplegia improve upper extremity function.

STUDY DESIGN:

Thirty children with hemiplegia, aged 2.5 to 10 years, were randomly assigned to receive: (1) a BTA injection into 1 or more of 3 muscle groups (biceps, volar forearm muscles, adductor pollicis) plus occupational therapy or (2) occupational therapy alone. Blinded outcomes obtained at baseline and at 1, 3, and 6 months included the Quality of Upper Extremity Skills Test (QUEST), goniometry measurements, grip strength, and Ashworth scores. The caregiver completed the self-care domain of the Pediatric Evaluation of Disability Inventory.

RESULTS:

Twenty-nine subjects completed the study. The QUEST demonstrated a significant improvement favoring the treatment group on a 2-way analysis of variance (F = 4.69, df = 1,83; P =.039). BTA treatment was also associated with an improvement in score on the self-care domain of the Pediatric Evaluation of Disability Inventory (F = 4.68, df = 1,82; P =.04).

CONCLUSIONS:

This study supports the effectiveness of BTA injections to improve upper extremity function of children with hemiplegia who have at least moderate spasticity.

PMID:
10969256
DOI:
10.1067/mpd.2000.108393
[Indexed for MEDLINE]

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