Effectiveness of Botulinum Toxin Injection With Casting in Children With Spastic Cerebral Palsy: A Randomized Controlled Trial

The most common form of movement disorder presented in children with cerebral palsy is spasticity, and dynamic equinus is the most common spastic ankle deformity. Botulinum toxin (BT) injection is now an established first-line treatment for focal spasticity. To assess the effects of BT injection wit...

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Bibliographic Details
Published in:Curēus (Palo Alto, CA) CA), 2024-06, Vol.16 (6), p.e61515
Main Authors: Vishwakarma, Shivansh, Kumar, Dileep, Garg, Ravindra Kumar, Gupta, Anil K, Singh, Ajai, Mishra, Sudhir, Yadav, Ganesh
Format: Article
Language:English
Subjects:
Ankle
Anticoagulants
Botulinum toxin
Cerebral palsy
Clinical trials
Drug dosages
General anesthesia
Orthopedics
Patients
Pediatrics
Phenols
Physical Medicine & Rehabilitation
Range of motion
Spasticity
Ultrasonic imaging
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Summary:The most common form of movement disorder presented in children with cerebral palsy is spasticity, and dynamic equinus is the most common spastic ankle deformity. Botulinum toxin (BT) injection is now an established first-line treatment for focal spasticity. To assess the effects of BT injection with casting in the treatment of dynamic equinus in children diagnosed with cerebral palsy with spastic diplegia. A prospective randomized controlled trial was conducted among patients aged 2-12 years with cerebral palsy and spastic diplegia, attending the general outpatient department and admitted to the indoor facility of the Department of Physical Medicine and Rehabilitation and the Department of Pediatric Orthopedics at King George's Medical University, Lucknow. Two groups of 19 patients each were formed. Group A received BT injection with casting, whereas in group B, only a cast was applied. Outcome measures including spasticity by Modified Ashworth Scale (MAS), Modified Tardieu Scale (MTS), range of motion (ROM), passive ankle dorsiflexion, and Gross Motor Function Measure (GMFM-66) (dimensions D and E) were assessed before and after the intervention. The participants in groups A and B were age-matched. A statistically significant difference was seen within group A and group B for MAS, passive ROM-dorsiflexion (PROM-DF), and passive ROM-plantarflexion (PROM-PF) at various follow-ups. In the 3rd week, MAS in each group was statistically insignificant (p-value> 0.05). There was a significant improvement in tone and a significant increase in the passive range of motion in both groups.
ISSN:2168-8184
2168-8184
DOI:10.7759/cureus.61515