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Accuracy of manual needle placement for gastrocnemius muscle in children with cerebral palsy checked against ultrasonography

Authors
 Eun Joo Yang  ;  Dong-wook Rha  ;  Jun Ki Yoo  ;  Eun Sook Park 
Citation
 ARCHIVES OF PHYSICAL MEDICINE AND REHABILITATION, Vol.90(5) : 741-744, 2009 
Journal Title
ARCHIVES OF PHYSICAL MEDICINE AND REHABILITATION
ISSN
 0003-9993 
Issue Date
2009
MeSH
Age Factors ; Botulinum Toxins, Type A/administration & dosage* ; Cerebral Palsy/diagnostic imaging ; Cerebral Palsy/drug therapy* ; Cerebral Palsy/rehabilitation ; Child ; Child, Preschool ; Confidence Intervals ; Electromyography ; Female ; Follow-Up Studies ; Humans ; Infant ; Injections, Intramuscular ; Logistic Models ; Male ; Muscle Relaxation/drug effects ; Muscle Spasticity ; Muscle, Skeletal/diagnostic imaging* ; Muscle, Skeletal/drug effects* ; Needles ; Odds Ratio ; Probability ; Prospective Studies ; Risk Assessment ; Sensitivity and Specificity ; Treatment Outcome ; Ultrasonography
Keywords
Botulinum toxins ; Cerebral palsy ; Gastrocnemius muscle ; Rehabilitation
Abstract
OBJECTIVE: To investigate the accuracy of manual needle placement into gastrocnemius muscle (GCM) for botulinum toxin type A (BTX-A) injection in children with spastic cerebral palsy (CP).

DESIGN: Prospective clinical study.

SETTING: University-affiliated hospital.

PARTICIPANTS: A total of 272 injections in GCMs of 39 children with spastic CP who were scheduled to receive BTX-A injections in GCMs.

INTERVENTION: Not applicable.

MAIN OUTCOME MEASURES: The accuracy of manual needle placement was checked against ultrasonography.

RESULTS: The needle was accurately inserted into GCM muscles in 78.7% of cases. Accuracy was 92.6% into gastrocnemius medialis (GM) and 64.7% into gastrocnemuis lateralis (GL). Muscle thickness at the needle insertion site was significantly thinner in GL than GM. Accuracy of GL in the younger age group (<4y, 57.6%) was lower than in the older age group (> or =4y, 78.1%). For GM, accuracy in both younger and older age groups was good (>90%).

CONCLUSIONS: Injection of the toxin into GCMs through the use of anatomic landmark was acceptable in GM, but not acceptable in GL, especially in young children.
Full Text
http://www.sciencedirect.com/science/article/pii/S0003999309000732
DOI
10.1016/j.apmr.2008.10.025
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Rehabilitation Medicine (재활의학교실) > 1. Journal Papers
Yonsei Authors
Rha, Dong Wook(나동욱) ORCID logo https://orcid.org/0000-0002-7153-4937
Park, Eun Sook(박은숙) ORCID logo https://orcid.org/0000-0002-9144-3063
Yang, Eun Joo(양은주)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/103677
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