OBJECTIVE: To observe the efficacy of acupuncture combined with METHODS: A total of 180 children with cerebral palsy were randomly divided into a combined group (60 cases, 2 cases dropped off), an acupuncture group (60 cases, 4 cases dropped off) and a Chinese medication group (60 cases, 5 cases dropped off). On the basis of conventional treatment, the children in the combined group were treated with acupuncture [Baihui (GV 20), Sishencong (EX-HN 1), Shenting (GV 24), Benshen (GB 13), 30 min each time, twice a day] and RESULTS: The total effective rate was 91.4% (53/58) in the combined group, which was higher than 80.4% (45/56) in the acupuncture group and 78.2% (43/55) in the Chinese medication group ( CONCLUSION Acupuncture combined with
Acupuncture Points ; Acupuncture Therapy ; Cerebral Palsy/drug therapy* ; Child ; Humans ; Powders ; Treatment Outcome

OBJECTIVETo assess therapeutic effect of combined treatment of Chinese medicine and western medicine on optic atrophy complicated by cerebral palsy.

METHODSOne hundred and seventeen cases were divided into an observation group (n = 79) and a control group (n = 38). The control group were treated with routine western medicine treatment including neurotrophic drugs and high pressure oxygen, etc. and the observation group with acupuncture at Ganshu (BL 18), Pishu (BL 20), Chengqi (ST 1), etc. and injection of 0.2-0.3 mL Compound Danshen Injectio into Qiuhou (EX-HN 7), on the basis of the same treatment of western medicine as that in the control group. Fundus examination and the tracing body angle detection were conducted before and after treatment and the therapeutic effects were assessed in the two groups.

RESULTSThe total effective rate was 91.1% in the observation group and 60.5% in the control group with a significant difference between the two groups (P < 0.001); after treatment the angle of tracing body significantly increased in the two groups (P < 0.01) with the observation group better than the control group (P < 0.01).

CONCLUSIONThe combined treatment of Chinese medicine and western medicine is an effective therapy for optic atrophy complicated by cerebral palsy.

Acupuncture Therapy ; Cerebral Palsy ; complications ; Combined Modality Therapy ; Drug Therapy ; Female ; Humans ; Infant ; Male ; Optic Atrophy ; therapy

Acupuncture Points ; Cerebral Palsy ; complications ; Drugs, Chinese Herbal ; administration & dosage ; Female ; Humans ; Infant ; Male ; Vision Disorders ; drug therapy ; etiology

PURPOSE: Hip adductor spasticity has a great impact on developing hip displacement in children with cerebral palsy (CP). Obturator nerve (ON) block is less invasive intervention rather than soft tissue surgery for reduction of hip adductor spasticity. The aim of this study is to investigate the effect of ON block on hip lateralization in low functioning children with spastic CP. MATERIALS AND METHODS: The study was performed by retrospective investigation of the clinical and radiographic follow-up data of low functioning children [gross motor function classification system (GMFCS) level III to V] with spastic cerebral palsy whose hip was subluxated. Migration percentage (MP) was measured on hip radiographs and its annual change was calculated. In intervention group, ON block was done with 50% ethyl alcohol under the guidance of electrical stimulation. RESULTS: The data of 49 legs of 25 children for intervention group and the data of 41 legs of 23 children for nonintervention group were collected. In intervention group, the MP were significantly reduced at 1st follow-up and the MPs at 2nd and last follow-up did not show significant differences from initial MP. Whereas in nonintervention group, the MPs at 1st, 2nd and last follow-up were all significantly increased compared to initial MPs. CONCLUSION: ON block with ethyl alcohol is useful as an early effective procedure against progressive hip displacement in these children with spastic CP.
Cerebral Palsy/*drug therapy ; Child ; Child, Preschool ; Ethanol/therapeutic use ; Female ; Humans ; Male ; Muscle Spasticity/drug therapy ; Nerve Block/*methods ; Obturator Nerve/*drug effects ; Retrospective Studies

Adolescent ; Botulinum Toxins ; administration & dosage ; therapeutic use ; Cerebral Palsy ; drug therapy ; Humans ; Male ; Muscle Spasticity ; drug therapy ; Neuromuscular Agents ; administration & dosage ; therapeutic use

PURPOSE: The purpose of the present study was to investigate whether electrical stimulation (ES) improves the paralytic effect of botulinum toxin type A (BTX-A) and evaluate the differences between low frequency (LF) and high frequency (HF) ES in children with spastic diplegic cerebral palsy (CP). MATERIALS and METHODS: Twenty-three children with spastic diplegia CP who had BTX-A injections into both gastrocnemius muscles were assessed. Following the toxin injection, electrical stimulation was given to 1 side of the injected muscles and a sham-stimulation to the other side for 30 min a day for 7 consecutive days [HFES (25Hz) to 11 children, LFES (4Hz) to 12 children]. The compound motor action potentials (CMAP) from the gastrocnemius muscle were assessed before injection and at 5 time points (days 3, 7, 14, 21, and 30) after injection. The clinical assessments of spasticity were performed before and 30 days after injection. RESULTS: The CMAP area became significantly lower in both LFES and HFES sides from 3 days after injection compared to baseline values. In other words, the CMAP area of the sham-stimulated side showed a significant decrease at 7 or 14 days after injection. However, there were no significant differences in clinical assessment of spasticity between the stimulated and sham-stimulated sides. CONCLUSION: Short-term ES in both LF and HF to the spastic muscles injected with BTX-A might induce earlier denervating action of BTX-A. However, it does not necessarily lead to clinical and electrophysiological benefits in terms of reduction of spasticity.
Botulinum Toxin Type A/*therapeutic use ; Cerebral Palsy/*drug therapy/*physiopathology ; Child, Preschool ; Electric Stimulation ; Electrophysiology ; Female ; Humans ; Male ; Paralysis/*drug therapy/*physiopathology

OBJECTIVETo study the therapeutic effects of different doses of botulinum toxin A (BTX-A) injection on tiptoe deformation in children with cerebral palsy.

METHODSA total of 256 children with tiptoe deformation due to spastic cerebral palsy were classified into group A (muscle tension levels I-II, n=147) and group B (muscle tension levels III-IV, n=109). Group A was randomly divided into group A1 (injected with high-dose BTX-A, n=73) and group A2 (injected with low-dose BTX-A, n=74). Group B was randomly divided into group B1 (injected with high-dose BTX-A, n=55) and group B2 ( injected with low-dose BTX-A, n=54). The dose of BTX-A was 6 U/kg for groups A1 and B1 and was 3 U/kg for groups A2 and B2. Before the injection and at 1,2,6, and 12 months after injection, the muscle tension of limbs was evaluated with the modified Ashworth Scale, and the recovery of motor function of lower limbs was assessed with the Gross Motor Function Measure (GMFM).

RESULTSBefore and after treatment, there were no significant differences in Ashworth and GMFM scores between groups A1 and A2 (P>0.05). After treatment, group B1 had a significantly reduced Ashworth score and a significantly increased GMFM score, and group B1 had a significantly lower Ashworth score and a significantly higher GMFM score compared with group B2 (P<0.05). For groups A and B, Ashworth score gradually declined post-treatment, reached the lowest point at 3 months after treatment, and returned to the level before treatment at 12 months after treatment; GMFM score gradually increased post-treatment and reached the peak level at 12 months after treatment (P<0.05).

CONCLUSIONSThe level of muscle tension should be considered when BTX-A injection is used for treating tiptoe deformation in children with cerebral palsy. It makes no difference to use high- or low-dose BTX-A when the muscle tension level is within I-II, but high-dose BTX-A has a better performance in reducing muscle tension and improving motor function when the muscle tension level is within III-IV.

Botulinum Toxins, Type A ; administration & dosage ; Cerebral Palsy ; complications ; drug therapy ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Injections ; Male ; Muscle Tonus ; drug effects ; Toes ; abnormalities

Botulinum Toxins, Type A ; administration & dosage ; adverse effects ; therapeutic use ; Cerebral Palsy ; drug therapy ; Child ; Child, Preschool ; Dose-Response Relationship, Drug ; Female ; Humans ; Male

OBJECTIVETo compare the effects of botulinum toxin A (BTX-A) injection guided by electric stimulation combined with physiotherapy, with physiotherapy only on the spasticity of the ankle plantar flexor in children with cerebral palsy (CP).

METHODSAfter signing the informed consent, 43 children with CP, aged 52.4 +/- 13.2 months (35 to 82 months), were randomly assigned into 2 groups, (1) BTX-A group (n = 23) treated with BTX-A injection guided by electric stimulation and (2) physiotherapy alone group (n = 20). Children in BTX-A group received injection of HengLi BTX-A in the ankle plantar flexors. A maximum dose of 12 units of BTX-A per kilogram body weight and maximumly 10 units of BTX-A per site were administered. Localization technique was the use of electrical stimulation guidance. Physiotherapy and ankle-foot orthosis were applied to children at 72 hours after injection in BTX-A group and at the time of being recruited into physiotherapy group. Ten days after entering into the study, the program was applied by the parents. Demographic data, including age, gender, number of the spastic lower limbs, affected side (left or right) were recorded. Clinical assessments included the range of passive movement (PROM) measured by goniometer while children maintained the knee extended, modified Ashworth scale (MAS), composite spasticity scale (CSS), D and E dimensions of the Gross Motor Function Measure (GMFM), and walking velocity (WV) was determined before treatment and at 2 weeks, 1, 2, and 3 months after treatment.

RESULTSNo statistically significant differences were found in age, gender, number of the spastic lower limbs, affected side, as well as clinical assessments (PROM, MAS, CSS, GMFM and WV) before treatment between the 2 groups (P > 0.05). All the children showed a reduction of spasticity (PROM, MAS and CSS) after 2 weeks, 1, 2, and 3 months of treatment (P < 0.05). When compared with the baseline findings, the improvement of standing and walking (GMFM), walking velocity were statistically significant after 2 weeks, 1, 2, and 3 months of treatment (P < 0.05). Furthermore, the differences of PROM, MAS and CSS between the 2 groups at 2 weeks, 1, 2, and 3 months examination were also statistically significant (after 3 months of treatment: t(PROM) = 6.48, t(MAS) = 9.74, t(CSS) = 9.59; P < 0.05). The difference in GMFM between the 2 groups was statistically significant (t(1M) = 2.20, t(2M) = 3.26, t(3M) = 4.13; P < 0.05) at 1, 2, and 3 months after treatment. The difference of WV between the 2 groups was statistically significant (t(2M) = 2.12, t(3M) = 2.57; P < 0.05) at 2 and 3 months after treatment.

CONCLUSIONBTX-A injection guided by electrical stimulation in combination with physiotherapy was more effective than physiotherapy alone in terms of reducing spasticity and improving functional performance in standing, walking, walking pattern and velocity on spasticity in ankle plantar flexors of ambulant children with CP.

Ankle Joint ; physiopathology ; Botulinum Toxins, Type A ; administration & dosage ; therapeutic use ; Cerebral Palsy ; drug therapy ; therapy ; Child ; Child, Preschool ; Electric Stimulation Therapy ; Female ; Gait ; Humans ; Male ; Muscle Spasticity ; drug therapy ; therapy

OBJECTIVETo investigate the clinical effect of mild warming moxibustion (MWM) on acupoints Shenque (RN8) and Guanyuan (RN4) for treatment of recurrent respiratory tract infection (RRTI) in children with cerebral palsy (CP).

METHODSSixty-four CP patients with RRTI were randomly and equally assigned to two groups, all received conventional rehabilitation treatment, but in acute infection stage, MWM was applied on the treated group, and intravenous dripping of immunoglobulin was given to the control group, all for 3 months. The frequency of RRTI attacking (Fre), the mean cough alleviating time (T-CA) and rale disappearing time (T-RA) during infection, as well as the serum levels of immune globulins during the post-treatment 1-year follow-up period were observed.

RESULTSThe effectiveness in the treated group was better than that in the control group, showing in aspects of Fre (2.38 +/- 0.64 times vs. 6.50 +/- 0.84 times), T-CA (3.92 +/- 1.32 days vs. 6.48 +/- 2.18 days) and T-RA (4.66 +/- 1.82 days vs. 7.64 +/- 1.44 days), significant difference was shown between groups (P < 0.01). The serum levels of IgG, IgM and IgA all raised in both two groups (P < 0.05), comparison of immunoglobulin levels between groups showed that they were lower immediately after treatment, but higher at the end of the 1-year follow-up in the treated group than those in the control group.

CONCLUSIONMWM on acupoints Shengue and Guanyuan has a better and long-term clinical effect for treatment of RRTI in children with CP.

Acupuncture Points ; Cerebral Palsy ; complications ; Child, Preschool ; Female ; Humans ; Infant ; Male ; Moxibustion ; methods ; Respiratory Tract Infections ; complications ; drug therapy ; prevention & control ; Secondary Prevention