Botulinum Toxin A Compared with Stretching Casts in the Treatment of Spastic Equinus: A Randomised Prospective Trial
Conservative therapies for equinus in cerebral palsy may help to postpone calf surgery in younger children. This study reports a prospective randomised trial of intramuscular botulinum toxin A (BtA) as an alternative to serial casting in 20 children with a dynamic component to calf equinus. Outcome...
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| Veröffentlicht in: | Journal of pediatric orthopaedics 1998-05, Vol.18 (3), p.304-311 |
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| container_title | Journal of pediatric orthopaedics |
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| creator | Corry, I S Cosgrove, A P Duffy, C M McNeill, S Taylor, T C Graham, H K |
| description | Conservative therapies for equinus in cerebral palsy may help to postpone calf surgery in younger children. This study reports a prospective randomised trial of intramuscular botulinum toxin A (BtA) as an alternative to serial casting in 20 children with a dynamic component to calf equinus. Outcome was assessed in the short term to show the effect of one treatment cycle. Assessments were by clinical examination, video gait analysis, and three-dimensional gait analysis. BtA was of efficacy similar to that of serial casting. Tone reduction in the BtA group allowed a more prolonged improvement in passive dorsiflexion, which may allow more opportunity for increase in muscle length. Gait analysis showed an improved mean ankle kinematic pattern in a subsection of both groups, which was maintained at 12 weeks in the BtA group, whereas the cast group relapsed. There were fewer side effects in the BtA group. Median time to reintervention was similar. |
| doi_str_mv | 10.1097/00004694-199805000-00006 |
| format | Article |
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This study reports a prospective randomised trial of intramuscular botulinum toxin A (BtA) as an alternative to serial casting in 20 children with a dynamic component to calf equinus. Outcome was assessed in the short term to show the effect of one treatment cycle. Assessments were by clinical examination, video gait analysis, and three-dimensional gait analysis. BtA was of efficacy similar to that of serial casting. Tone reduction in the BtA group allowed a more prolonged improvement in passive dorsiflexion, which may allow more opportunity for increase in muscle length. Gait analysis showed an improved mean ankle kinematic pattern in a subsection of both groups, which was maintained at 12 weeks in the BtA group, whereas the cast group relapsed. There were fewer side effects in the BtA group. Median time to reintervention was similar.</description><identifier>ISSN: 0271-6798</identifier><identifier>EISSN: 1539-2570</identifier><identifier>DOI: 10.1097/00004694-199805000-00006</identifier><identifier>PMID: 9600553</identifier><identifier>CODEN: JPORDO</identifier><language>eng</language><publisher>Hagerstown, MD: Lippincott-Raven Publishers</publisher><subject>Biological and medical sciences ; Botulinum Toxins, Type A - adverse effects ; Botulinum Toxins, Type A - therapeutic use ; Casts, Surgical - adverse effects ; Cerebral Palsy - complications ; Cerebral Palsy - physiopathology ; Child ; Child, Preschool ; Diseases of the osteoarticular system. Orthopedic treatment ; Equinus Deformity - drug therapy ; Equinus Deformity - etiology ; Equinus Deformity - therapy ; Female ; Gait ; Humans ; Injections, Intramuscular ; Male ; Medical sciences ; Observer Variation ; Prospective Studies ; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects)</subject><ispartof>Journal of pediatric orthopaedics, 1998-05, Vol.18 (3), p.304-311</ispartof><rights>Lippincott-Raven Publishers.</rights><rights>1998 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c2676-32ea71d80793c0d0eb42b9c7958f364ad6d6efa4f1dbf66022a8b9536a220ce43</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=2230569$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/9600553$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Corry, I S</creatorcontrib><creatorcontrib>Cosgrove, A P</creatorcontrib><creatorcontrib>Duffy, C M</creatorcontrib><creatorcontrib>McNeill, S</creatorcontrib><creatorcontrib>Taylor, T C</creatorcontrib><creatorcontrib>Graham, H K</creatorcontrib><title>Botulinum Toxin A Compared with Stretching Casts in the Treatment of Spastic Equinus: A Randomised Prospective Trial</title><title>Journal of pediatric orthopaedics</title><addtitle>J Pediatr Orthop</addtitle><description>Conservative therapies for equinus in cerebral palsy may help to postpone calf surgery in younger children. This study reports a prospective randomised trial of intramuscular botulinum toxin A (BtA) as an alternative to serial casting in 20 children with a dynamic component to calf equinus. Outcome was assessed in the short term to show the effect of one treatment cycle. Assessments were by clinical examination, video gait analysis, and three-dimensional gait analysis. BtA was of efficacy similar to that of serial casting. Tone reduction in the BtA group allowed a more prolonged improvement in passive dorsiflexion, which may allow more opportunity for increase in muscle length. Gait analysis showed an improved mean ankle kinematic pattern in a subsection of both groups, which was maintained at 12 weeks in the BtA group, whereas the cast group relapsed. There were fewer side effects in the BtA group. Median time to reintervention was similar.</description><subject>Biological and medical sciences</subject><subject>Botulinum Toxins, Type A - adverse effects</subject><subject>Botulinum Toxins, Type A - therapeutic use</subject><subject>Casts, Surgical - adverse effects</subject><subject>Cerebral Palsy - complications</subject><subject>Cerebral Palsy - physiopathology</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Diseases of the osteoarticular system. Orthopedic treatment</subject><subject>Equinus Deformity - drug therapy</subject><subject>Equinus Deformity - etiology</subject><subject>Equinus Deformity - therapy</subject><subject>Female</subject><subject>Gait</subject><subject>Humans</subject><subject>Injections, Intramuscular</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Observer Variation</subject><subject>Prospective Studies</subject><subject>Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. 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Orthopedic treatment</topic><topic>Equinus Deformity - drug therapy</topic><topic>Equinus Deformity - etiology</topic><topic>Equinus Deformity - therapy</topic><topic>Female</topic><topic>Gait</topic><topic>Humans</topic><topic>Injections, Intramuscular</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Observer Variation</topic><topic>Prospective Studies</topic><topic>Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects)</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Corry, I S</creatorcontrib><creatorcontrib>Cosgrove, A P</creatorcontrib><creatorcontrib>Duffy, C M</creatorcontrib><creatorcontrib>McNeill, S</creatorcontrib><creatorcontrib>Taylor, T C</creatorcontrib><creatorcontrib>Graham, H K</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><jtitle>Journal of pediatric orthopaedics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Corry, I S</au><au>Cosgrove, A P</au><au>Duffy, C M</au><au>McNeill, S</au><au>Taylor, T C</au><au>Graham, H K</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Botulinum Toxin A Compared with Stretching Casts in the Treatment of Spastic Equinus: A Randomised Prospective Trial</atitle><jtitle>Journal of pediatric orthopaedics</jtitle><addtitle>J Pediatr Orthop</addtitle><date>1998-05</date><risdate>1998</risdate><volume>18</volume><issue>3</issue><spage>304</spage><epage>311</epage><pages>304-311</pages><issn>0271-6798</issn><eissn>1539-2570</eissn><coden>JPORDO</coden><abstract>Conservative therapies for equinus in cerebral palsy may help to postpone calf surgery in younger children. This study reports a prospective randomised trial of intramuscular botulinum toxin A (BtA) as an alternative to serial casting in 20 children with a dynamic component to calf equinus. Outcome was assessed in the short term to show the effect of one treatment cycle. Assessments were by clinical examination, video gait analysis, and three-dimensional gait analysis. BtA was of efficacy similar to that of serial casting. Tone reduction in the BtA group allowed a more prolonged improvement in passive dorsiflexion, which may allow more opportunity for increase in muscle length. Gait analysis showed an improved mean ankle kinematic pattern in a subsection of both groups, which was maintained at 12 weeks in the BtA group, whereas the cast group relapsed. There were fewer side effects in the BtA group. Median time to reintervention was similar.</abstract><cop>Hagerstown, MD</cop><pub>Lippincott-Raven Publishers</pub><pmid>9600553</pmid><doi>10.1097/00004694-199805000-00006</doi><tpages>8</tpages></addata></record> |
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| source | MEDLINE; Journals@Ovid Complete |
| subjects | Biological and medical sciences Botulinum Toxins, Type A - adverse effects Botulinum Toxins, Type A - therapeutic use Casts, Surgical - adverse effects Cerebral Palsy - complications Cerebral Palsy - physiopathology Child Child, Preschool Diseases of the osteoarticular system. Orthopedic treatment Equinus Deformity - drug therapy Equinus Deformity - etiology Equinus Deformity - therapy Female Gait Humans Injections, Intramuscular Male Medical sciences Observer Variation Prospective Studies Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects) |
| title | Botulinum Toxin A Compared with Stretching Casts in the Treatment of Spastic Equinus: A Randomised Prospective Trial |
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