TY - JOUR
T1 - EFFECT OF ADDITION OF BOTULINUM TOXIN-A TO STANDARDIZED THERAPY FOR DYNAMIC MANUAL SKILLS MEASURED WITH KINEMATIC AIMING TASKS IN CHILDREN WITH SPASTIC HEMIPLEGIA
AU - Rameckers, Eugene A.
AU - Duysens, Jacques
AU - Speth, Lucianne A. W. M.
AU - Vles, Hans J. S.
AU - Smits-Engelsman, Bouwien C. M.
PY - 2010/4
Y1 - 2010/4
N2 - Objective: To measure the effect of intensive therapy and the lasting effect of a standardized functional training programme with vs. without the addition of chemodernervation of the muscles of the forearm and hand. Patients and methods: Twenty children with spastic hemiplegia, aged 4-16 years, were matched for baseline characteristics and randomized to standardized task-oriented therapy for 6 months with or without botulinum toxin injections. Dynamic kinematic outcome measures were: speed, accuracy, end-point spread and performance. Measurements of active and passive range of motion, stretch-restricted angle of the elbow and wrist, Ashworth scores and Melbourne Assessment of Unilateral Upper Limb Function were made. All measures were performed at baseline, 2 weeks after injection of botulinum toxin and after 6 months (at the end of therapy), and 3 months after end of the therapy. Results: Clinical measures showed improvement in both groups. However, no significant differences emerged between groups on functional measures. Directly after the botulinum toxin injection all kinematic outcome measures showed a decrease, but baseline values were re-established during the therapy period. After botulinum toxin injections a temporarily significant greater increase in speed and performance was found. These results illustrate the need for further quantitative research into the effects of botulinum toxin.
AB - Objective: To measure the effect of intensive therapy and the lasting effect of a standardized functional training programme with vs. without the addition of chemodernervation of the muscles of the forearm and hand. Patients and methods: Twenty children with spastic hemiplegia, aged 4-16 years, were matched for baseline characteristics and randomized to standardized task-oriented therapy for 6 months with or without botulinum toxin injections. Dynamic kinematic outcome measures were: speed, accuracy, end-point spread and performance. Measurements of active and passive range of motion, stretch-restricted angle of the elbow and wrist, Ashworth scores and Melbourne Assessment of Unilateral Upper Limb Function were made. All measures were performed at baseline, 2 weeks after injection of botulinum toxin and after 6 months (at the end of therapy), and 3 months after end of the therapy. Results: Clinical measures showed improvement in both groups. However, no significant differences emerged between groups on functional measures. Directly after the botulinum toxin injection all kinematic outcome measures showed a decrease, but baseline values were re-established during the therapy period. After botulinum toxin injections a temporarily significant greater increase in speed and performance was found. These results illustrate the need for further quantitative research into the effects of botulinum toxin.
KW - cerebral palsy
KW - kinematic aiming tasks
KW - spasticity
KW - upper limb
KW - task-oriented therapy
KW - botulinum toxin-A
KW - randomized clinical trial
U2 - 10.2340/16501977-0521
DO - 10.2340/16501977-0521
M3 - Article
C2 - 20461335
SN - 1650-1977
VL - 42
SP - 332
EP - 338
JO - Journal of Rehabilitation Medicine
JF - Journal of Rehabilitation Medicine
IS - 4
ER -