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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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Published in: | Curēus (Palo Alto, CA) CA), 2024-06, Vol.16 (6), p.e61515 |
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description | 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. |
doi_str_mv | 10.7759/cureus.61515 |
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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.</description><identifier>ISSN: 2168-8184</identifier><identifier>EISSN: 2168-8184</identifier><identifier>DOI: 10.7759/cureus.61515</identifier><identifier>PMID: 38957257</identifier><language>eng</language><publisher>United States: Cureus Inc</publisher><subject>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</subject><ispartof>Curēus (Palo Alto, CA), 2024-06, Vol.16 (6), p.e61515</ispartof><rights>Copyright © 2024, Vishwakarma et al.</rights><rights>Copyright © 2024, Vishwakarma et al. This work is published under https://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>Copyright © 2024, Vishwakarma et al. 2024 Vishwakarma et al.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.proquest.com/docview/3086607348/fulltextPDF?pq-origsite=primo$$EPDF$$P50$$Gproquest$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/3086607348?pq-origsite=primo$$EHTML$$P50$$Gproquest$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,25753,27924,27925,37012,37013,44590,53791,53793,75126</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38957257$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Vishwakarma, Shivansh</creatorcontrib><creatorcontrib>Kumar, Dileep</creatorcontrib><creatorcontrib>Garg, Ravindra Kumar</creatorcontrib><creatorcontrib>Gupta, Anil K</creatorcontrib><creatorcontrib>Singh, Ajai</creatorcontrib><creatorcontrib>Mishra, Sudhir</creatorcontrib><creatorcontrib>Yadav, Ganesh</creatorcontrib><title>Effectiveness of Botulinum Toxin Injection With Casting in Children With Spastic Cerebral Palsy: A Randomized Controlled Trial</title><title>Curēus (Palo Alto, CA)</title><addtitle>Cureus</addtitle><description>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.</description><subject>Ankle</subject><subject>Anticoagulants</subject><subject>Botulinum toxin</subject><subject>Cerebral palsy</subject><subject>Clinical trials</subject><subject>Drug dosages</subject><subject>General anesthesia</subject><subject>Orthopedics</subject><subject>Patients</subject><subject>Pediatrics</subject><subject>Phenols</subject><subject>Physical Medicine & Rehabilitation</subject><subject>Range of motion</subject><subject>Spasticity</subject><subject>Ultrasonic imaging</subject><issn>2168-8184</issn><issn>2168-8184</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>PIMPY</sourceid><recordid>eNpdkc9LHDEUx4O0qFhvPUugl15W82MmyXgpOvhjQbC0W3ocMpk3bpZMsiYz4nro396I26Ke3oPPhy_fx0PoMyXHUpbViZkiTOlY0JKWO2ifUaFmiqriw6t9Dx2mtCKEUCIZkWQX7XFVlZKVch_9ueh7MKN9AA8p4dDj8zBOzvppwIvwaD2e-9WzEDz-bcclrnUarb_DmdRL67oIW_Bz_UwMriFCG7XD37VLm1N8hn9o34XBPkGH6-DHGJzL6yJa7T6hj33W4HA7D9Cvy4tFfT27ub2a12c3szUTfJyBEbJiDIiRRlVtWxS8KorK6FKaTgLRjHS8FZCNSnDSq67kTLLWQKs4KTQ_QN9ectdTO0BnINfQrllHO-i4aYK2zVvi7bK5Cw8NpYxKJYuc8HWbEMP9BGlsBpsMOKc9hCk1nMiSy4oKltUv79RVmKLP92VLCUEkL1S2jl5X-t_l32_4X4Rtk4c</recordid><startdate>20240602</startdate><enddate>20240602</enddate><creator>Vishwakarma, Shivansh</creator><creator>Kumar, Dileep</creator><creator>Garg, Ravindra Kumar</creator><creator>Gupta, Anil K</creator><creator>Singh, Ajai</creator><creator>Mishra, Sudhir</creator><creator>Yadav, Ganesh</creator><general>Cureus Inc</general><general>Cureus</general><scope>NPM</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20240602</creationdate><title>Effectiveness of Botulinum Toxin Injection With Casting in Children With Spastic Cerebral Palsy: A Randomized Controlled Trial</title><author>Vishwakarma, Shivansh ; Kumar, Dileep ; Garg, Ravindra Kumar ; Gupta, Anil K ; Singh, Ajai ; Mishra, Sudhir ; Yadav, Ganesh</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-p263t-ec67922e0c7c89bb4439449ca57cd7e0a20d3b6e2e09630f8d53272bceb8304a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Ankle</topic><topic>Anticoagulants</topic><topic>Botulinum toxin</topic><topic>Cerebral palsy</topic><topic>Clinical trials</topic><topic>Drug dosages</topic><topic>General anesthesia</topic><topic>Orthopedics</topic><topic>Patients</topic><topic>Pediatrics</topic><topic>Phenols</topic><topic>Physical Medicine & Rehabilitation</topic><topic>Range of motion</topic><topic>Spasticity</topic><topic>Ultrasonic imaging</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Vishwakarma, Shivansh</creatorcontrib><creatorcontrib>Kumar, Dileep</creatorcontrib><creatorcontrib>Garg, Ravindra Kumar</creatorcontrib><creatorcontrib>Gupta, Anil K</creatorcontrib><creatorcontrib>Singh, Ajai</creatorcontrib><creatorcontrib>Mishra, Sudhir</creatorcontrib><creatorcontrib>Yadav, Ganesh</creatorcontrib><collection>PubMed</collection><collection>ProQuest Central (Corporate)</collection><collection>ProQuest_Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>AUTh Library subscriptions: ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Curēus (Palo Alto, CA)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Vishwakarma, Shivansh</au><au>Kumar, Dileep</au><au>Garg, Ravindra Kumar</au><au>Gupta, Anil K</au><au>Singh, Ajai</au><au>Mishra, Sudhir</au><au>Yadav, Ganesh</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Effectiveness of Botulinum Toxin Injection With Casting in Children With Spastic Cerebral Palsy: A Randomized Controlled Trial</atitle><jtitle>Curēus (Palo Alto, CA)</jtitle><addtitle>Cureus</addtitle><date>2024-06-02</date><risdate>2024</risdate><volume>16</volume><issue>6</issue><spage>e61515</spage><pages>e61515-</pages><issn>2168-8184</issn><eissn>2168-8184</eissn><abstract>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.</abstract><cop>United States</cop><pub>Cureus Inc</pub><pmid>38957257</pmid><doi>10.7759/cureus.61515</doi><oa>free_for_read</oa></addata></record> |
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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 |
title | Effectiveness of Botulinum Toxin Injection With Casting in Children With Spastic Cerebral Palsy: A Randomized Controlled Trial |
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