Delayed series casting after botulinum toxin injection is more effective for equinus children with spastic cerebral palsy
10.3760/cma.j.issn.0254-1424.2020.04.004
- VernacularTitle:肉毒毒素注射后延迟系列石膏固定治疗痉挛型脑瘫伴马蹄足患儿的疗效观察
- Author:
Zhengqing GE
1
;
Fei HE
;
Bo YU
;
Yingchu ZHAO
;
Wenhua CHEN
;
Yun MIAO
Author Information
1. 上海市第一人民医院康复医学科，上海 200080
- From:
Chinese Journal of Physical Medicine and Rehabilitation
2020;42(4):307-311
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To compare the efficacy of series casting with different timings after botulinum toxin injection among equinus children with spastic cerebral palsy.Methods:Sixty-three equinus children with spastic cerebral palsy were randomly divided into a control group and an experimental group. After being injected with botulinum toxin type A, 4 weeks of series casting was applied immediately in the control group, while in the experimental group it was applied 2 weeks later. Both groups were given basic rehabilitation therapy including heel walking, kicking balls, single-leg standing, standing platform training and balance training. The modified Tardieu scale, three-dimensional gait analysis, gross motor function measure 88 (GMFM-88) and a self-made questionnaire were used to evaluate muscle tone, spasticity, gait parameters, standing and walking before the treatment and 2 and 6 months afterward.Results:Immediately after the treatment there was a significant improvement in both groups′ average MTS scores (R1, R2, R1-R2 with knee extension and flexion), dorsiflexion at initial contact, peak dorsiflexion in the stance and swing phases, and dimension D (standing), and also in their average GMFM-88 (walking) scores. Two and six months later the experimental group′s average MTS scores, peak dorsiflexion in the stance phase, and dimension D (standing) score in the GMFM-88 (walking) had improved significantly compared with the control group′s averages. However, no significant differences were observed between the two groups in any of the other measurements after the treatment.Conclusion:Delaying series casting after botulinum toxin A injection can significantly reduce tone and spasticity in the plantarflexors, improve the range of motion and functioning of the ankle, and alleviate the discomfort and pain caused by series casting.
