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The effect of botulinum toxin type A injection into the gastrocnemius muscle on sit-to-stand transfer in children with spastic diplegic cerebral palsy

 Eun Sook Park  ;  Chang Il Park  ;  Hyun Chung Chang  ;  Chan Woo Park  ;  Don Shin Lee 
 CLINICAL REHABILITATION, Vol.20(8) : 668-674, 2006 
Journal Title
Issue Date
Ankle ; Botulinum Toxins, Type A/administration & dosage* ; Case-Control Studies ; Cerebral Palsy/complications* ; Child ; Child, Preschool ; Humans ; Injections, Intramuscular ; Muscle Spasticity/drug therapy* ; Muscle Spasticity/etiology ; Muscle, Skeletal/drug effects* ; Neuromuscular Agents/administration & dosage*
OBJECTIVE: To investigate the benefit of botulinum toxin type A injection into the ankle plantarflexor muscle on sit-to-stand transfer in children with spastic diplegic cerebral palsy.
DESIGN: Case-control study.
SETTING: Inpatients in a university-affiliated hospital.
SUBJECTS: Forty spastic diplegic children aged from 2 to 6 years (18 children with botulinum toxin type A injection into both gastrocnemius muscles as an experimental group and 14 children without injection as a control group).
MAIN MEASURES: Sit-to-stand transfer task was evaluated using a motion analyser (Vicon 370 MA with six infrared cameras). The tests were performed twice with a two- week interval. The changes in temporal, kinematic and kinetic parameters were investigated in each group.
RESULTS: In the control group there were no significant changes in any of the measured parameters between the tests. In the experimental group, total duration (s) of sit-to-stand transfer was shortened after injection (4.35 +/- 2.49 to 2.89 +/- 1.48, P < 0.05). The maximal angles (degrees) of pelvic and hip joints were reduced (28.88 +/- 5.53 to 26.57 +/- 3.73 and 90.78+8.69 to 87.23 +/- 8.76) and the initial angle of ankle dorsiflexion was increased (4.41 +/- 6.16 to 7.08 +/- 6.09) after injection (P < 0.05). The maximal moments (Nm/kg) of the hip and knee joints (0.44 +/- 0.17 to 0.51 +/- 0.21 and 0.13 +/- 0.05 to 0.18 +/- 0.14) were increased while that of the ankle joint was reduced (0.32 +/- 0.09 to 0.28 +/- 0.10) after injection (P < 0.05). Only the cases with greater reduction of spasticity showed an improvement on kinematic and kinetic parameters.
CONCLUSION: Botulinum toxin type A injection into spastic ankle plantarflexors led to better accomplishment of sit-to-stand transfer in children with spastic diplegic cerebral palsy.
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1. College of Medicine (의과대학) > Dept. of Rehabilitation Medicine (재활의학교실) > 1. Journal Papers
Yonsei Authors
Park, Eun Sook(박은숙) ORCID logo https://orcid.org/0000-0002-9144-3063
Park, Chang Il(박창일)
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