Yonsei Med J.  2010 Jul;51(4):579-584. 10.3349/ymj.2010.51.4.579.

Short-Term Effects of Combined Serial Casting and Botulinum Toxin Injection for Spastic Equinus in Ambulatory Children with Cerebral Palsy

Affiliations
  • 1Department and Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul, Korea. iamchangwh@naver.com
  • 2Departments of Physical Medicine and Rehabilitation, National Health Insurance Corporation Ilsan Hospital, Goyang, Korea.

Abstract

PURPOSE
The purpose of this paper is to test the hypothesis that combination therapy of serial cast and botulinum toxin type A (BTX-A) injection can further enhance the effects of a BTX-A injection in ambulant children with cerebral palsy (CP) who have an equinus foot.
MATERIALS AND METHODS
Children in group A (30 legs of 21 children) received a serial casting application after an injection of BTX-A, and children in group B (25 legs of 17 children) received only a BTX-A injection. Assessments were performed before the intervention and 1 month after the intervention.
RESULTS
After the intervention, there were significant improvements in tone, dynamic spasticity, and passive range of motion (ROM) in both groups. However, the changes were greater in group A than in group B. Dimension D (standing) in Gross Motor Function Measure (GMFM)-66 was significantly improved in group A but not in group B. On the other hand, there were no significant changes in di-mension E (walking, running, jumping) in GMFM-66 in either group.
CONCLUSION
The results of our study suggest that a serial casting application after BTX-A injection can enhance the benefits of BTX-A injection in children with cerebral palsy.

Keyword

Serial cast; botulinum toxin; equinus; cerebral palsy
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