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Botulinum neurotoxin type A responders among children with spastic cerebral palsy: Pattern-specific effects.
Papageorgiou, E; Peeters, N; Staut, L; Molenaers, G; Ortibus, E; Van Campenhout, A; Desloovere, K.
Afiliación
  • Papageorgiou E; KU Leuven Department of Rehabilitation Sciences, Leuven, Belgium; Clinical Motion Analysis Laboratory, University Hospitals Leuven, Leuven, Belgium. Electronic address: Eirini.papageorgiou@kuleuven.be.
  • Peeters N; KU Leuven Department of Rehabilitation Sciences, Leuven, Belgium; Clinical Motion Analysis Laboratory, University Hospitals Leuven, Leuven, Belgium.
  • Staut L; KU Leuven Department of Rehabilitation Sciences, Leuven, Belgium; Clinical Motion Analysis Laboratory, University Hospitals Leuven, Leuven, Belgium.
  • Molenaers G; KU Leuven, Locomotor and Neurological Disorders, Department of Development and Regeneration, Leuven, Belgium; Department of Orthopedics, University Hospitals Leuven, Leuven, Belgium.
  • Ortibus E; KU Leuven, Locomotor and Neurological Disorders, Department of Development and Regeneration, Leuven, Belgium; Center for Developmental Disabilities, Leuven, Belgium.
  • Van Campenhout A; KU Leuven, Locomotor and Neurological Disorders, Department of Development and Regeneration, Leuven, Belgium; Department of Orthopedics, University Hospitals Leuven, Leuven, Belgium.
  • Desloovere K; KU Leuven Department of Rehabilitation Sciences, Leuven, Belgium; Clinical Motion Analysis Laboratory, University Hospitals Leuven, Leuven, Belgium.
Eur J Paediatr Neurol ; 49: 131-140, 2024 Mar.
Article en En | MEDLINE | ID: mdl-38518417
ABSTRACT

AIM:

To identify short-term effects of botulinum neurotoxin type A (BoNT) injections on gait and clinical impairments, in children with spastic cerebral palsy (CP), based on baseline gait pattern-specific subgroups.

METHOD:

Short-term effects of BoNT injections in the medial hamstrings and gastrocnemius were defined in a retrospective convenience sample of 117 children with CP (median age 6 years 4 months; GMFCS I/II/III 70/31/16; unilateral/bilateral 56/61) who had received gait analyses before and 2 months post-BoNT. First, baseline gait patterns were classified. Statistical and meaningful changes were calculated between pre- and post-BoNT lower limb sagittal plane kinematic waveforms, the gait profile score, and non-dimensional spatiotemporal parameters for the entire sample and for pattern-specific subgroups. These gait waveforms per CP subgroup at pre- and post-BoNT were also compared to typically developing gait and composite scores for spasticity, weakness, and selectivity were compared between the two conditions.

RESULTS:

Kinematic improvements post-BoNT were identified at the ankle and knee for the entire sample, and for subgroups with apparent equinus and jump gait. Limbs with baseline patterns of dropfoot and to a lesser extent true equinus showed clear improvements only at the ankle. In apparent equinus, jump gait, and dropfoot, spasticity improved post-BoNT, without leading to increased weakness or diminished selectivity. Compared to typical gait, knee and hip motion improved in the crouch gait subgroup post-BoNT.

CONCLUSION:

This comprehensive analysis highlighted the importance of investigating BoNT effects on gait and clinical impairments according to baseline gait patterns. These findings may help identify good treatment responders.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Parálisis Cerebral / Toxinas Botulínicas Tipo A / Fármacos Neuromusculares Límite: Adolescent / Child / Child, preschool / Female / Humans / Male Idioma: En Revista: Eur J Paediatr Neurol Asunto de la revista: NEUROLOGIA / PEDIATRIA Año: 2024 Tipo del documento: Article Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Parálisis Cerebral / Toxinas Botulínicas Tipo A / Fármacos Neuromusculares Límite: Adolescent / Child / Child, preschool / Female / Humans / Male Idioma: En Revista: Eur J Paediatr Neurol Asunto de la revista: NEUROLOGIA / PEDIATRIA Año: 2024 Tipo del documento: Article Pais de publicación: Reino Unido