Treatment Effects of Botulinum Toxin A in Cerebral Palsy with Foot Deformities.
- Author:
Gi Young PARK
1
;
Sung Koo JANG
Author Information
1. Department of Rehabilitation Medicine, Yonsei University College of Medicine.
- Publication Type:Original Article
- Keywords:
Botulinum toxin A;
Cerebral palsy;
Foot deformities;
Roentgenograms
- MeSH:
Ankle;
Ankle Joint;
Botulinum Toxins*;
Cerebral Palsy*;
Child;
Congenital Abnormalities;
Contracture;
Follow-Up Studies;
Foot Deformities*;
Foot*;
Hemiplegia;
Humans;
Joints;
Muscle Spasticity;
Muscle, Skeletal;
Muscles;
Talus;
Weight-Bearing
- From:Journal of the Korean Academy of Rehabilitation Medicine
1998;22(1):21-26
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
The purpose of this study is to evaluate the effectiveness of intramuscular botulinum toxin A injection in cerebral palsy with foot deformities using roentgenogram. We have studied 26 children with cerebral palsy(age 3 to 13 years old). They were twenty spastic diplegias, three hemiplegias and three mixed types(spasticity and athetosis). The botulinum toxin A was injected into gastrocnemius or peroneous muscles with an electromyographic guidance. Before injections, passive joint angles of the ankle were assessed by the goniometric measurements. A plantar-flexion angle of talus, dorsiflexion angle of calcaneous, and talar-calcaneal divergence angle were measured using the lateral and anterior-posterior roentgenograms of the foot with weight- bearing for the assessment of equinovalgus of ankle. Follow-up assessments were performed at 1 and 3 months after the injection. At 1 month after the injection into gastrocnemius muscle, there was an increased range of passive ankle joint motion, decreased plantar-flexion angle of talus, and increased dorsiflexion angle of calcaneous. These changes were still significant at 3 months after the injection. After the injection into peroneous muscle, the talar-calcaneal divergence angle was significantly decreased. This study provides the evidence that the treatment with botulinum toxin A improves the ankle joint motion in cerebral palsy with feet deformities by reducing hypertonicity, spasticity and dynamic contracture. In addition, the lateral and anterior- posterior roentgenograms of the foot with weight bearing seems to be the simple and objective methods to evaluate the effectiveness of intramuscular botulinum toxin A injection in cerebral palsy with foot deformities.
