Back to Search
Start Over
Long-term effects of repeated botulinum neurotoxin A, bimanual training, and splinting in young children with cerebral palsy.
- Source :
-
Developmental Medicine & Child Neurology . Feb2020, Vol. 62 Issue 2, p252-258. 7p. - Publication Year :
- 2020
-
Abstract
- <bold>Aim: </bold>To investigate long-term development of hand function after repeated botulinum neurotoxin A (BoNT-A) and occupational therapy at a young age.<bold>Method: </bold>Twenty children with unilateral spastic cerebral palsy (CP) (14 males, six females; median inclusion age 3y 1mo, range 1y 11mo-4y 3mo) participated in this longitudinal study. Ten children received occupational therapy after a randomized controlled trial and 10 repeated BoNT-A plus occupational therapy during 1-year. The Assisting Hand Assessment (AHA) and active supination, assessed the following 3 years. The assessments were compared with data from a reference group to investigate development over time.<bold>Results: </bold>The improvement in AHA (7.5 AHA units) after BoNT-A plus occupational therapy was maintained at final follow-up. The occupational therapy group, unchanged after 1-year, improved by 5 AHA units (96% confidence interval [CI] 2-10), thus there was no difference between the groups. Median active supination increased in comparison with the reference group. In the BoNT-A/occupational therapy group, 9 out of 10 (97.85% CI 45 115) children improved in active supination. In the occupational therapy group, 7 out of 10 (97.85% CI -2 to 68) children improved in active supination. No correlation between active supination and AHA was found.<bold>Interpretation: </bold>Bimanual performance achieved after BoNT-A plus occupational therapy was maintained, while it increased by follow-up in the occupational therapy group, suggesting that combined intervention gave earlier access to bimanual skills. Active supination was unrelated to AHA.<bold>What This Paper Adds: </bold>Children whose bimanual performance improved after botulinum neurotoxin A and/or occupational therapy, maintained skills or progressed during follow-up. Bimanual performance increased with age, similar to a quality-register reference group. Increased active supination after intervention improved at follow-up but was not related to bimanual performance. [ABSTRACT FROM AUTHOR]
- Subjects :
- *BOTULINUM A toxins
*CHILDREN with cerebral palsy
*OCCUPATIONAL therapy for children
*BOTULINUM toxin
*OCCUPATIONAL therapy
*CEREBRAL palsy treatment
*RESEARCH
*MUSCLE relaxants
*RESEARCH methodology
*SPLINTS (Surgery)
*EVALUATION research
*MEDICAL cooperation
*TREATMENT effectiveness
*COMPARATIVE studies
*HAND
*RESEARCH funding
*COMBINED modality therapy
*CEREBRAL palsy
*LONGITUDINAL method
*MOTOR ability
Subjects
Details
- Language :
- English
- ISSN :
- 00121622
- Volume :
- 62
- Issue :
- 2
- Database :
- Academic Search Index
- Journal :
- Developmental Medicine & Child Neurology
- Publication Type :
- Academic Journal
- Accession number :
- 141155607
- Full Text :
- https://doi.org/10.1111/dmcn.14298