Review
Orthopedics
Krongkaew Klaewkasikum, Tanyaporn Patathong, Patarawan Woratanarat, Thira Woratanarat, Kunlawat Thadanipon, Sasivimol Rattanasiri, Ammarin Thakkinstian
Summary: This study evaluated the efficacy of conservative treatments for spastic equinus foot in children with cerebral palsy. The findings suggest that Botulinum toxin A (BoNT-A) and casting contribute to gait improvement and ankle dorsiflexion at knee extension. BoNT-A showed a greater number of gait improvements compared to placebo, and it had an additive effect to physical therapy for passive ankle dorsiflexion. Orthosis was found to be useful for ankle dorsiflexion at initial contact.
JOURNAL OF ORTHOPAEDIC SURGERY AND RESEARCH
(2022)
Review
Pediatrics
Shang-A Hung, Chung-Lun Liao, Wei-Pin Lin, Jason C. Hsu, Yao-Hong Guo, Yu-Ching Lin
Summary: BoNT-A injections are shown to be safe and effective for controlling drooling in children with cerebral palsy, with effects lasting over 3 months, but the dosage should not exceed 4 units/kg. Further studies are needed to determine the optimal dosage and target glands.
Article
Neurosciences
Nicholas Sclavos, Pam Thomason, Elyse Passmore, Kerr Graham, Erich Rutz
Summary: Background: Gastrocsoleus lengthening (GSL) is a common surgical procedure for treating equinus deformity in ambulant children with cerebral palsy (CP). However, foot drop can still occur post-operatively. The study aimed to identify which children would develop persistent foot drop after GSL surgery for equinus and found that children with hemiplegia had a higher frequency of foot drop compared to children with diplegia. The study suggests the need for new management approaches for this important and unresolved problem.
Article
Biophysics
Alyssa M. Spomer, Robin Z. Yan, Michael H. Schwartz, Katherine M. Steele
Summary: Muscle synergy analysis is commonly used to study motor control. This study compared synergies in normal individuals and individuals with cerebral palsy (CP) in different gait patterns. The results showed that altered gait patterns are not the primary driver of changes in synergies, highlighting the value of using synergies to capture patient-specific motor control differences.
JOURNAL OF BIOMECHANICS
(2022)
Article
Food Science & Technology
Fabiola Reyes, Hannah A. Shoval, Amy Tenaglia, Heakyung Kim
Summary: Cerebral palsy is a non-progressive disorder that affects motor function in children. This study investigated the use of ultrasound-guided onabotulinumtoxinA injections in patients with cerebral palsy and oromandibular dystonia, and found that the treatment improved eating abilities, communication, and had no significant adverse effects.
Article
Food Science & Technology
Mariam Hull, Mered Pames, Joseph Jankovic
Summary: Opisthotonus is a condition characterized by abnormal trunk extension and arching due to excessive contractions of the paraspinal muscles. It is most commonly seen in children with dystonia secondary to hypoxic injury or other acquired and genetic causes. Treatment options include oral medications, muscle injections, and deep brain stimulation, although management in the pediatric population has not been systematically reviewed.
Article
Food Science & Technology
Yookyung Lee, Seungeun Lee, Joonyoung Jang, Jiwoon Lim, Ju Seok Ryu
Summary: The study showed that injecting botulinum toxin into the hip adductor muscles significantly reduced spasticity, preventing hip dislocation in patients with cerebral palsy. Multiple injections over time effectively lowered muscle tone and decreased hip displacement.
Review
Pharmacology & Pharmacy
Stramkauskaite Almina, Ylaite Karile, Prasauskiene Audrone, Bakaniene Indre
Summary: The review found supportive evidence for the efficacy of botulinum toxin therapy for muscle hypertonia related pain in non-ambulant children with cerebral palsy (GMFCS levels IV and V). However, conflicting results were found for children in GMFCS levels I to III, possibly due to the heterogeneity of the studies and/or weak study design. Mixed evidence was also found for the use of BTX to reduce postoperative pain, likely due to differences in surgical methods, injection protocols, and outcome measures.
Article
Food Science & Technology
Mariam Hull, Mered Parnes, Joseph Jankovic
Summary: Self-injurious behaviors are repetitive and persistent actions that cause physical harm to oneself. They are often seen in individuals with neurodevelopmental and neuropsychiatric conditions, particularly those with intellectual disability. These behaviors can be severe and life-threatening, making them difficult to treat. However, the use of botulinum neurotoxin injections has shown promise in preventing or reducing self-injury in children.
Review
Medicine, General & Internal
Ebru Yilmaz Yalcinkaya, Evrim Karadag Saygi, Ozden Ozyemisci Taskiran, Nalan Capan, Sehim Kutlay, Birkan Sonel Tur, E. L. Ozlem, Ece Unlu Akyuz, Suda Tekin, Demet Ofluoglu, Murat Zinnuroglu, Pinar Akpinar, Tugce Ozekli Misirlioglu, Berrin Huner, Hakan Nur, Sibel Caglar, Melek Sezgin, Canan Tikiz, Kadriye Ones, Afitap Icagasioglu, Resa Aydin
Summary: Spasticity is the most common motor disturbance in cerebral palsy (CP). The COVID-19 outbreak has disrupted spasticity treatment plans, including delays in botulinum toxin (BoNT) injections, leading to challenges in managing focal spasticity in children with CP. Experts recommend conservative management approaches as initial steps and advocate for BoNT injections with appropriate indications and precautions during the pandemic.
TURKISH JOURNAL OF MEDICAL SCIENCES
(2021)
Review
Rehabilitation
Nalinda D. Andraweera, Prabha H. Andraweera, Zohra S. Lassi, Venugopal Kochiyil
Summary: This systematic review assessed the use of BTX-A in the management of mobility-related outcomes among adult persons with spastic CP. Results showed effectiveness in improving spasticity-related outcomes, but mixed results for functional outcomes were found. More studies with exclusive CP cohorts and long-term follow-up are needed for better evaluation of BTX-A effectiveness.
AMERICAN JOURNAL OF PHYSICAL MEDICINE & REHABILITATION
(2021)
Article
Pharmacology & Pharmacy
Dimitrios N. Varvarousis, Dimitris Dimopoulos, George I. Vasileiadis, Ioannis Manolis, Avraam Ploumis
Summary: The study provides evidence that intramuscular injection of botulinum toxin is beneficial for patients suffering from spasticity due to chronic stroke, resulting in improvement in gait parameters and reduction in spasticity.
Review
Medicine, General & Internal
Norine Ma, Nicholas Sclavos, Elyse Passmore, Pam Thomason, Kerr Graham, Erich Rutz
Summary: The study found that surgical lengthening of the gastrocsoleus muscle-tendon unit can significantly improve swing phase kinematics in children with cerebral palsy. However, there is still variability in the effectiveness of treating recurrent equinus and calcaneus, indicating the need for further research to determine the best treatment strategy.
MEDICINA-LITHUANIA
(2021)
Article
Medicine, General & Internal
Nicholas Sclavos, Norine Ma, Elyse Passmore, Pam Thomason, H. Kerr Graham, Erich Rutz
Summary: There is evidence that ankle dorsiflexor function improves after gastrocsoleus lengthening (GSL) surgery for equinus deformity in ambulant children with cerebral palsy. However, it is currently unclear whether this improvement correlates with reduced foot drop or which children would benefit from Tibialis Anterior Tendon Shortening (TATS).
MEDICINA-LITHUANIA
(2022)
Article
Pediatrics
Axel Horsch, Lara Petzinger, Maher Ghandour, Cornelia Putz, Tobias Renkawitz, Marco Goetze
Summary: This study aimed to evaluate functional changes in gait analysis in relation to maximum dorsiflexion and define the cutoff value for a functionally relevant equinus foot in CP patients. The results showed that a clinical dorsiflexion value of ≤5 degrees had the most evident functional changes.