Architectural Changes of the Gastrocnemius Muscle after Botulinum Toxin Type A Injection in Children with Cerebral Palsy.
10.3349/ymj.2014.55.5.1406
- Author:
Eun Sook PARK
1
;
Eungeol SIM
;
Dong Wook RHA
;
Soojin JUNG
Author Information
1. Department of Rehabilitation Medicine, Severance Hospital, Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul, Korea. werch@yuhs.ac
- Publication Type:Original Article
- Keywords:
Botulinum toxin type A;
ultrasonic imaging;
cerebral palsy
- MeSH:
Acetylcholine Release Inhibitors/*adverse effects/therapeutic use;
Botulinum Toxins/*adverse effects/therapeutic use;
Cerebral Palsy/*drug therapy;
Child;
Child, Preschool;
Female;
Humans;
Male;
Muscle, Skeletal/anatomy & histology/*drug effects/ultrasonography
- From:Yonsei Medical Journal
2014;55(5):1406-1412
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: This study used ultrasonography (US) to investigate the architectural changes in gastrocnemius muscles (GCM) after botulinum toxin injection (BoNT-A) in children with cerebral palsy (CP). MATERIALS AND METHODS: Thirteen children with CP who received a BoNT-A injection into their GCM to treat equinus were recruited (9 males and 4 females). Architectural changes in both the medial and lateral heads of the GCM from a total of 20 legs were assessed using B-mode, real-time US. Muscle thickness (MT), fascicle length (FL), and fascicle angle (FA) were measured over the middle of the muscle belly in both a resting and neutral ankle position. Measures at 1 and 3 months after the injection were compared with baseline data taken before the injection. RESULTS: The mean age of the subjects was 5.8 (+/-1.6) years. Spasticity was significantly reduced when measured by both the modified Tardieu scale and the modified Ashworth scale at 1 and 3 months after injection (p<0.05). The MT and FA of both the medial and lateral heads of the GCM were significantly reduced for both neutral and resting ankle positions at 1 and 3 months after the injection. The FL of both the medial and lateral heads of the GCM were significantly increased in a resting position (p<0.05), but not in a neutral position. CONCLUSION: Our results demonstrated muscle architectural changes induced by BoNT-A injection. The functional significances of these changes were discussed.
