Document Detail


Botulinum toxin, physical and occupational therapy, and neuromuscular electrical stimulation to treat spastic upper limb of children with cerebral palsy: a pilot study.
MedLine Citation:
PMID:  20447049     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Spasticity has been successfully managed with different treatment modalities or combinations. No information is available on the effectiveness or individual contribution of botulinum toxin type A (BTA) combined with physical and occupational therapy and neuromuscular electrical stimulation to treat spastic upper limb. The purpose of this study was to assess the effects of such treatment and to inform sample-size calculations for a randomized controlled trial. BTA was injected into spastic upper limb muscles of 10 children. They received 10 sessions of physical and occupational therapy followed by 10 sessions of neuromuscular electrical stimulation on the wrist extensors (antagonist muscles). Degree of spasticity using the Modified Ashworth scale, active range of motion, and manual function with the Jebsen hand test, were assessed. Meaningful improvement was observed in hand function posttreatment (P = 0.03). Median spasticity showed a reduction trend and median amplitude of wrist range of motion registered an increase; however, neither of these were significant (P > 0.05). There is evidence of a beneficial effect of the combined treatment. Adequate information has been obtained on main outcome-measurement variability for calculating sample size for a subsequent study to quantify the treatment effect precisely.
Authors:
Gerardo Rodríguez-Reyes; Aldo Alessi-Montero; Leticia Díaz-Martínez; Antonio Miranda-Duarte; Alberto Isaac Pérez-Sanpablo
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Artificial organs     Volume:  34     ISSN:  1525-1594     ISO Abbreviation:  Artif Organs     Publication Date:  2010 Mar 
Date Detail:
Created Date:  2010-05-07     Completed Date:  2010-07-28     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7802778     Medline TA:  Artif Organs     Country:  United States    
Other Details:
Languages:  eng     Pagination:  230-4     Citation Subset:  IM    
Affiliation:
Department of Prosthetics and Orthotics, Instituto Nacional de Rehabilitación, Mexico City, Mexico. grodriguezreyes@gmail.com
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MeSH Terms
Descriptor/Qualifier:
Biomechanics
Botulinum Toxin Type A / administration & dosage,  therapeutic use*
Cerebral Palsy / diagnosis,  physiopathology,  therapy*
Child
Child, Preschool
Combined Modality Therapy
Disability Evaluation
Electric Stimulation Therapy*
Feasibility Studies
Female
Humans
Injections, Intramuscular
Male
Muscle Spasticity
Neuromuscular Agents / administration & dosage,  therapeutic use*
Occupational Therapy*
Physical Therapy Modalities*
Pilot Projects
Range of Motion, Articular
Severity of Illness Index
Treatment Outcome
Upper Extremity / innervation,  physiopathology*
Wrist / physiopathology
Chemical
Reg. No./Substance:
0/Botulinum Toxin Type A; 0/Neuromuscular Agents

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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