Effect of botulinum toxin A injection in the treatment of gastrocnemius spasticity in children aged 9-36 months with cerebral palsy: a prospective study

Abstract:

Objective To investigate the long-term clinical efficacy and adverse effects of botulinum toxin-A(BTX-A) injection in the treatment of gastrocnemius spasticity in children aged 9-36 months with cerebral palsy.Methods Eighty children aged 9-36 months with cerebral palsy and gastrocnemius spasticity were selected and randomly divided into a BTX-A injection group and a conventional treatment group(n=40 each).The children in the BTX-A injection group received injections of BTX-A guided by color Doppler ultrasound and 4 courses of rehabilitation training after injection.Those in the conventional treatment group received 4 courses of the same rehabilitation training alone.Before treatment and at 1, 2, 3, and 6 months after treatment, the modified Tardieu scale(MTS) was applied to assess the degree of gastrocnemius spasticity, the values in the passive state measured by surface electromyography(sEMG) were applied to evaluate muscle tension, and the Gross Motor Function Measure(GMFM) was used to evaluate gross motor function.Results Compared with the conventional treatment group, the BTX-A injection group had significantly greater reductions in MTS score and the values in the passive state measured by sEMG(P<0.05), as well as significantly greater increases in joint angles R1 and R2 in MTS and gross motor score in GMFM(P<0.05).No serious adverse reactions related to BTX-A injection were found.Conclusions BTX-A injection is effective and safe in the treatment of gastrocnemius spasticity in children aged 9-36 months with cerebral palsy.