Clinical value of electrical stimulation-guided botulinum toxin type A injection for lower limb spasticity in cerebral palsy children

Objective To evaluate the clinical value of electrical stimulation-guided botulinum toxin type A injection for lower limb spasticity in cerebral palsy children.Methods After signing the informed consent,50 cerebral palsy children with lower limb spasticity were treated with botulinum toxin type A(BTX-A) injection guided by electric stimulation.Demographic data,including age,gender,number of the spastic lower limbs,aftected side(left or right) were recorded.Clinical assessments including the range of passive movement and muscular tension were determined before treatment and at 3d,7d,1 month,2 months,and 3 months after treatment.Physiotherapy was applied to children at 72h after injection,and ankle-foot orthosis were applied to children at 7d after injection.Results Lower limb function started to improve after 3d of treatment,peaked at 1-2 weeks,and lasted for 3 months.Lower limb joint angles started to improve after 3d of treatment(P0.001) and peaked at 1-2 weeks(P0.001).The effect decreased 3 months after injection,but the children were still significantly improved compared with the parameters measured pre-injection.The changes showed on the Modified Ashworth Scale of the spastic muscle were consistent with the improvement seen with the other measures of range of motion.The Gross Motor Function Measure increased significantly 1 month post-injection and this change was observed to persist for a few months.Conclusion BTX-A injection guided by electrical stimulation in combination with physiotherapy can reduce spasticity and improve functional performance in standing,walking,walking pattern and velocity on spasticity in ankle plantar flexors of ambulant children with cerebral palsy.