EFFECT OF ADDITION OF BOTULINUM TOXIN-A TO STANDARDIZED THERAPY FOR DYNAMIC MANUAL SKILLS MEASURED WITH KINEMATIC AIMING TASKS IN CHILDREN WITH SPASTIC HEMIPLEGIA

Eugene A. Rameckers*, Jacques Duysens, Lucianne A. W. M. Speth, Hans J. S. Vles, Bouwien C. M. Smits-Engelsman

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

7 Citations (Web of Science)

Abstract

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.
Original languageEnglish
Pages (from-to)332-338
JournalJournal of Rehabilitation Medicine
Volume42
Issue number4
DOIs
Publication statusPublished - Apr 2010

Keywords

  • cerebral palsy
  • kinematic aiming tasks
  • spasticity
  • upper limb
  • task-oriented therapy
  • botulinum toxin-A
  • randomized clinical trial

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