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Pediatr Phys Ther. 2002 Fall;14(3):132-44.

Impairment, disability, and satisfaction outcomes after lower-extremity botulinum toxin a injections for children with cerebral palsy.

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The Research Center for Children with Special Health Care Needs (M.A.F., H.M.D.) and Physical Therapy Department (K.J.R.), Franciscan Children’s Hospital and Rehabilitation Center, Boston, Mass; and Programs in Rehabilitation Sciences, Drexel University (M.E.O.), Philadelphia, Pa.



The purpose of this study was to document impairment, disability, and parent satisfaction outcomes for children with cerebral palsy who received botulinum toxin A (BtA) injections.


Seven children, three to 11 years old, participated in this multiple single-subject AB design study. Impairment, disability, and satisfaction outcomes were documented using passive range of motion measurements, Modified Ashworth Scale scores, and the Canadian Occupational Performance Measure. These outcomes were measured every two weeks during the two-month baseline phase and the four-month intervention phase. Outcomes for each child were graphed and visually analyzed for changes in level, trend, and slope.


After BtA injections, all children demonstrated an increase in passive range of motion and a decrease in spasticity in at least some of the injected muscles. Six of the seven children demonstrated improvements in disability and parent satisfaction outcomes.


Improvement in a variety of outcomes may be observed after BtA injections in children with cerebral palsy and lower-extremity spasticity who are ambulatory.

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