Clinical study of botulinum toxin A injection in the treatment of lower extremity in spastic hemiplegic cerebral palsied children

【Objective】 To investigate the clinical effects of Botulinum toxin A injection in the treatment of lower extremity in spastic hemiplegic cerebral palsied children. 【Methods】 42 ambulant CP children(39～86 months old) with spastic hemiplegia were chosen.They were randomly divided into 2 groups.BTX-A group(n=22) received BTX-A injection and RT,the injection sites were gastrocnemius and adductors.Control group(n=20) treated with RT alone.The composite spasticity scale(CSS),D and E dimensions of the gross motor function measure(GMFM-88),gait evaluation(affected and nonaffected step length and walking velocity) were conducted for every child in the BTX-A group before BTX-A injection and at 2 weeks and 2 months after the injection.Also,these evaluation protocols were performed for every child in the control group at the same time.All children in 2 groups were treated with RT for 3 months. 【Results】 No statistically differents were found in CSS,GMFM(G,E) and gait index before treatment between the 2 groups(P0.05).In BTX-A group,CSS showed significant decrease following injection when compared with the baseline findings and the control group(P0.01 or 0.05).Significant differences were noted in BTX-A group in regard to GMFM,nonaffected step length and walking velicity(P0.05).While no significant improvement was measured in respect to GMFM and gait evaluatoin(P0.05). 【Conclusion】 In spastic hemiplegic CP,Botulinum toxin A has a better effects on tone reduction and improvement on gait and skilled motor function.