Ultrasound-guided botulinum toxin type A injection combined with rehabilitation therapy on plantarflexion deformity caused by lower limbs spasticity in children with cerebral palsy: A clinical efficacy observation

Objective To observe the clinical efficacy of ultrasound-guided botulinum toxin type A (BTX-A) injection combined with rehabilitation therapy on plantarflexion deformity in cerebral palsy (CP) children with lower limbs spasticity.Methods Forty-seven CP children with plantarflexion deformity caused by lower limb spasticity were selected,and were divided into injection group (24 cases) and control group (23 cases) according to the random number table.Both groups were given rehabilitation therapy.The injection group received ultrasoundguided BTX-A injection as an addition.All children were given comprehensive assessment of lower limb spasticity before BTX-A treatment and 2 weeks,1 month,3 months and 6 months after the treatment by use of the modified Ashworth scale (MAS),ankle passive range of motion (PROM) and gross motor function measurement scale-88 (GMFM-88) D area (standing) and E area(walking,running and jumping).Results At baseline,there were not significantly differences between the two groups in terms of MAS,PROM and GMFM-88 (P ＞ 0.05).At 2 weeks,1 month,3 months and 6 months after the treatment,the injection group improved significantly with regard to all the parameters when compared to the baseline (P ＜ 0.05).The control group also improved with all the parameters at 1,3 and 6 months after the treatment (P ＜ 0.05).It was also shown that the injection group improved to a significantly greater extent than the control group at all the time points after treatment with regard to all the assessment parameters (P ＜ 0.05).Conclusion Ultrasound-guided BTX-A injection combined with rehabilitation therapy can quickly relieve the plantarflexion deformity in CP children.It is worthy of clinical application and promotion. Key words: Botulinum toxin;  Ultrasound;  Cerebral palsy;  Lower limb spasticity;  Plantarflexion deformity;  Rehabilitation therapy