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Architectural Changes of the Gastrocnemius Muscle after Botulinum Toxin Type A Injection in Children with Cerebral Palsy

Authors
 Eun Sook Park  ;  Eungeol Sim  ;  Dong-Wook Rha  ;  Soojin Jung 
Citation
 YONSEI MEDICAL JOURNAL, Vol.55(5) : 1406-1412, 2014 
Journal Title
YONSEI MEDICAL JOURNAL
ISSN
 0513-5796 
Issue Date
2014
MeSH
Acetylcholine Release Inhibitors/adverse effects* ; Acetylcholine Release Inhibitors/therapeutic use ; Botulinum Toxins/adverse effects* ; Botulinum Toxins/therapeutic use ; Cerebral Palsy/drug therapy* ; Child ; Child, Preschool ; Female ; Humans ; Male ; Muscle, Skeletal/anatomy & histology ; Muscle, Skeletal/diagnostic imaging ; Muscle, Skeletal/drug effects* ; Ultrasonography
Keywords
Botulinum toxin type A ; cerebral palsy ; ultrasonic imaging
Abstract
PURPOSE:
This study used ultrasonography (US) to investigate the architectural changes in gastrocnemius muscles (GCM) after botulinum toxin injection (BoNT-A) in children with cerebral palsy (CP).
MATERIALS AND METHODS:
Thirteen children with CP who received a BoNT-A injection into their GCM to treat equinus were recruited (9 males and 4 females). Architectural changes in both the medial and lateral heads of the GCM from a total of 20 legs were assessed using B-mode, real-time US. Muscle thickness (MT), fascicle length (FL), and fascicle angle (FA) were measured over the middle of the muscle belly in both a resting and neutral ankle position. Measures at 1 and 3 months after the injection were compared with baseline data taken before the injection.
RESULTS:
The mean age of the subjects was 5.8 (±1.6) years. Spasticity was significantly reduced when measured by both the modified Tardieu scale and the modified Ashworth scale at 1 and 3 months after injection (p<0.05). The MT and FA of both the medial and lateral heads of the GCM were significantly reduced for both neutral and resting ankle positions at 1 and 3 months after the injection. The FL of both the medial and lateral heads of the GCM were significantly increased in a resting position (p<0.05), but not in a neutral position.
CONCLUSION:
Our results demonstrated muscle architectural changes induced by BoNT-A injection. The functional significances of these changes were discussed.
Files in This Item:
T201403352.pdf Download
DOI
10.3349/ymj.2014.55.5.1406
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
Sim, Eun Geol(심은결)
Jung, Soo Jin(정수진)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/99889
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