1. Efficacy of Repeated Botulinum Toxin Type A Injections for Spastic Equinus in Children with Cerebral Palsy—A Secondary Analysis of the Randomized Clinical Trial
- Author
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Bo Young Hong, Sang-Jee Lee, Hyun Jung Chang, Soyoung Lee, Jeong-Yi Kwon, and Joo Hyun Park
- Subjects
Male ,medicine.medical_specialty ,Adolescent ,onabotulinumtoxin A ,Health, Toxicology and Mutagenesis ,lcsh:Medicine ,Toxicology ,Article ,law.invention ,Cerebral palsy ,03 medical and health sciences ,0302 clinical medicine ,Randomized controlled trial ,law ,medicine ,Spastic ,Humans ,cerebral palsy ,spasticity ,botulinum toxin ,letibotulinumtoxin A ,equinus ,Spasticity ,Botulinum Toxins, Type A ,Child ,030222 orthopedics ,business.industry ,lcsh:R ,medicine.disease ,Botulinum toxin ,Gait ,Surgery ,Clinical trial ,Muscle Spasticity ,Anesthesia ,Observational study ,medicine.symptom ,business ,030217 neurology & neurosurgery ,medicine.drug - Abstract
Botulinum toxin A is considered an important tool to control spasticity in children with cerebral palsy. Several factors are known to affect the efficacy of botulinum toxin, such as dosage, appropriate muscle selection and application, age, and accompanying therapy. A multicenter, double-blind, randomized, prospective phase III clinical trial of botulinum toxin A for the treatment of dynamic equinus in 144 children with cerebral palsy was performed to compare the efficacies of letibotulinumtoxin A and onabotulinumtoxin A. Secondary analyses were performed to evaluate factors that affected the outcome, focusing on the number of times injections were repeated. Effectiveness was defined as a change of 2 or more in the physician’s rating scale. Multivariate regression analyses were performed with multiple variables. The first injection of botulinum toxin A significantly improved D subscale of Gross Motor Function Measure-88 scores at 3 months compared to repeated injections (p < 0.05). After 6 months, patients who had one injection or none before the study showed significantly better outcomes than those who had more than one injection in terms of observational gait scores.
- Published
- 2017