Andrew, Morag J., Montague‐Johnson, Christine, Laler, Karen, Baker, Bonny, Sullivan, Peter B., Parr, Jeremy R., Qi, Cathy, and Montague-Johnson, Christine
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Fehlings, Darcy, Brown, Leah, Harvey, Adrienne, Himmelmann, Kate, Lin, Jean‐Pierre, Macintosh, Alexander, Mink, Jonathan W., Monbaliu, Elegast, Rice, James, Silver, Jessica, Switzer, Lauren, Walters, Ilana, and Lin, Jean-Pierre
Subjects
NEUROSURGERY, TREATMENT of dystonia, CEREBRAL palsy treatment, SYSTEMATIC reviews, TREATMENT effectiveness, MUSCLE relaxants, BACLOFEN, CEREBRAL palsy, COMPARATIVE studies, DYSTONIA, RESEARCH methodology, MEDICAL cooperation, RESEARCH, EVALUATION research, DEEP brain stimulation, DISEASE complications, THERAPEUTICS
Abstract
Copyright of Developmental Medicine & Child Neurology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Warnink‐Kavelaars, Jessica, Vermeulen, R Jeroen, Buizer, Annemieke I, and Becher, Jules G
Subjects
CEREBRAL palsy treatment, BOTULINUM toxin, THERAPEUTICS, CHILDREN with cerebral palsy, TREATMENT effectiveness, ELECTRIC stimulation, MEDICAL protocols, CEREBRAL palsy, COMPARATIVE studies, INJECTIONS, INTRAMUSCULAR injections, RESEARCH methodology, MEDICAL cooperation, MUSCLE relaxants, RESEARCH, EVALUATION research, SKELETAL muscle
Abstract
Aim: To validate a detailed intramuscular needle placement protocol using passive muscle stretching and relaxing for botulinum neurotoxin type A (BoNT-A) treatment in the lower extremity of children with spastic cerebral palsy (CP), with verification by electrical stimulation.Method: A prospective observational study was performed in 75 children with spastic CP who received regular BoNT-A treatment under general anaesthesia (52 males, 23 females; mean age 8y 9mo, SD 3y 7mo, range 4-18y; mean body mass index 16.2, SD 3.7, range 7.7-26.7). A total of 1084 intramuscular needle placements using passive muscle stretching and relaxing were verified by electrical stimulation. Primary outcome was the positive predictive value.Results: Intramuscular needle placement in the muscles adductor brevis, adductor longus, gracilis, semimembranosus, semitendinosus, biceps femoris, rectus femoris, and lateral and medial heads of the gastrocnemius and soleus had a positive predictive value ranging from 85.7% to 100% (95% confidence interval ranging from 71.5-89.9% to 91.4-100%).Interpretation: This validated detailed protocol for intramuscular needle placement using passive muscle stretching and relaxing for BoNT-A treatment in the lower extremity of children with spastic CP is reliable and has a high positive predictive value. [ABSTRACT FROM AUTHOR]