Upper-extremity Spasticity-reducing Treatment in Adjunct to Movement Training and Orthoses in Children with Cerebral Palsy at Gross Motor Function- and Manual Ability Classification System Levels IV-V: A Descriptive Study

Covering a 20-year period of work with children with severe cerebral palsy (CP) within a Swedish habilitation service, changes in passive wrist extension with fingers extended (PWE-FE) and current hand function are described and compared between children receiving systematic upper-extremity treatmen...

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Bibliographic Details
Published in:Developmental neurorehabilitation 2020-08, Vol.23 (6), p.349-358
Main Authors: Andersson, Gerd, Renström, Barbro, Blaszczyk, Izabela, Domellöf, Erik
Format: Article
Language:English
Subjects:
botulinum toxin
Botulinum Toxins, Type A - administration & dosage
Botulinum Toxins, Type A - therapeutic use
Cerebral Palsy - pathology
Cerebral Palsy - rehabilitation
Cerebral Palsy - therapy
Child
Child, Preschool
Combined Modality Therapy
development
Exercise Therapy - methods
Female
Hand - physiopathology
hand function
Humans
Injections, Intramuscular
Male
Movement
Muscle Spasticity
Neurological Rehabilitation - methods
Neuromuscular Agents - administration & dosage
Neuromuscular Agents - therapeutic use
Orthotic Devices
passive wrist extension
Rehabilitation Medicine
rehabiliteringsmedicin
Severe cerebral palsy
Severity of Illness Index
upper-extremity interventions
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Summary:Covering a 20-year period of work with children with severe cerebral palsy (CP) within a Swedish habilitation service, changes in passive wrist extension with fingers extended (PWE-FE) and current hand function are described and compared between children receiving systematic upper-extremity treatment with botulinum neurotoxin type A and intervention programs from before 7 years of age (Group 1, n = 7), those whom for various reasons did not undergo this treatment (Group 2, n = 10), and those not having the option to receive treatment until later during childhood/adolescence (Group 3, n = 8). Group 3 showed more critical and less normal PWE-FE values for both wrists, and poorer hand function scores, particularly compared with Group 1. Findings cautiously suggest that repeated upper-extremity spasticity-reducing treatment and movement training/orthoses from an early age may help prevent critical loss of passive range of motion of the wrist joint flexion/extension and promote hand function development in children with severe CP.
ISSN:1751-8423
1751-8431
1751-8431
DOI:10.1080/17518423.2019.1655677