Effects of botulinum toxin type A injection plus biofeedback therapy on motor function in children with spastic cerebral palsy

Objective To explore the effects of botulinum toxin-A (BTX-A) injection plus biofeedback therapy on lower limb motor function with spastic cerebral palsy. Methods A total of 31 spastic cerebral palsy children from February to December 2012 were divided into observation group (n=15) and control group (n=16) respectively. All cases received systematic rehabilitation therapy for 3 months. The observation group was injected with BTX-A at baseline and received biofeedback therapy and other rehabilitations at Day 1 post-injection. Modified Ashworth scale (MAS), composite spasticity scale (CSS) and passive range of ankle motion (PROM) were assessed at baseline, Days 3, 7, 14, 30 and 90 post-therapy. And gross motor function measure-88 and walking velocity were examined at baseline and Day 90 post-therapy. Results In observation group, the MAS pre- and 3, 7, 14, 30, 90 d post-treatment were 2.6±0.6, 2.0±0.5, 1.2±0.5, 0.6±0.6, 0.5±0.6, 1.0±0.5; CSS were 14.1±1.1, 12.0±1.1, 10.2±1.2, 8.2±1.4, 8.0±1.5, 9.0±1.6 respectively; PROM were (-8.5±9.4)°, (-1.5±7.6)°, (6.9±8.3)°, (11.7±6.8)°, (15.2±6.6)°, (13.7±7.8)°respectively. All children showed significant decreases in spasticity (MAS, CSS, PROM) and improvements in GMFM and walking velocity. And the difference of children in observation group was earlier than that in control group. Statistically significant differences existed between two groups in MAS, CSS and PROM (P<0.01). There were also statistically significant differences between two groups in GMFM-88, stand and walking function scores, walking velocity (P<0.05). Conclusion BTX-A injection plus biofeedback therapy can quickly and effectively improve lower extremity motor function in children with spastic cerebral palsy. Key words: Botulinum toxin type A; Biofeedback(psychology); Cerebral palsy