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

Cited by  1 articles

The Effect and Complication of Botulinum Toxin Type A Injection with Serial Casting for the Treatment of Spastic Equinus Foot
Sook Joung Lee, In Young Sung, Dae Hyun Jang, Jin Hwa Yi, Jin Ho Lee, Ju Seok Ryu
Ann Rehabil Med. 2011;35(3):344-353.    doi: 10.5535/arm.2011.35.3.344.


Reference

1. Brouwer B, Davidson LK, Olney SJ. Serial casting in idiopathic toe-walkers and children with spastic cerebral palsy. J Pediatr Orthop. 2000. 20:221–225.
2. Corry IS, Cosgrove AP, Duffy CM, McNeill S, Taylor TC, Graham HK. Botulinum toxin A compared with stretching casts in the treatment of spastic equinus: a randomised prospective trial. J Pediatr Orthop. 1998. 18:304–311.
3. McNee AE, Will E, Lin JP, Eve LC, Gough M, Morrissey MC, et al. The effect of serial casting on gait in children with cerebral palsy: preliminary results from a crossover trial. Gait Posture. 2007. 25:463–468.
Article
4. Galli M, Cimolin V, Valente EM, Crivellini M, Ialongo T, Albertini G. Computerized gait analysis of botulinum toxin treatment in children with cerebral palsy. Disabil Rehabil. 2007. 29:659–664.
Article
5. Sätilä H, Pietikäinen T, Iisalo T, Lehtonen-Räty P, Salo M, Haataja R, et al. Botulinum toxin type A injections into the calf muscles for treatment of spastic equinus in cerebral palsy: a randomized trial comparing single and multiple injection sites. Am J Phys Med Rehabil. 2008. 87:386–394.
Article
6. Bang MS, Chung SG, Kim SB, Kim SJ. Change of dynamic gastrocnemius and soleus muscle length after block of spastic calf muscle in cerebral palsy. Am J Phys Med Rehabil. 2002. 81:760–764.
Article
7. Papadonikolakis AS, Vekris MD, Korompilias AV, Kostas JP, Ristanis SE, Soucacos PN. Botulinum A toxin for treatment of lower limb spasticity in cerebral palsy: gait analysis in 49 patients. Acta Orthop Scand. 2003. 74:749–755.
Article
8. Gajdosik RL. Passive extensibility of skeletal muscle: review of the literature with clinical implications. Clin Biomech (Bristol, Avon). 2001. 16:87–101.
Article
9. Tardieu G, Tardieu C, Colbeau-Justin P, Lespargot A. Muscle hypoextensibility in children with cerebral palsy: II. Therapeutic implications. Arch Phys Med Rehabil. 1982. 63:103–107.
10. Desloovere K, Molenaers G, Jonkers I, De Cat J, De Borre L, Nijs J, et al. A randomized study of combined botulinum toxin type A and casting in the ambulant child with cerebral palsy using objective outcome measures. Eur J Neurol. 2001. 8:Suppl 5. 75–87.
Article
11. Brouwer B, Wheeldon RK, Stradiotto-Parker N, Allum J. Reflex excitability and isometric force production in cerebral palsy: the effect of serial casting. Dev Med Child Neurol. 1998. 40:168–175.
12. Cottalorda J, Gautheron V, Metton G, Charmet E, Chavrier Y. Toe-walking in children younger than six years with cerebral palsy. The contribution of serial corrective casts. J Bone Joint Surg Br. 2000. 82:541–544.
13. Glanzman AM, Kim H, Swaminathan K, Beck T. Efficacy of botulinum toxin A, serial casting, and combined treatment for spastic equinus: a retrospective analysis. Dev Med Child Neurol. 2004. 46:807–811.
Article
14. Kay RM, Rethlefsen SA, Fern-Buneo A, Wren TA, Skaggs DL. Botulinum toxin as an adjunct to serial casting treatment in children with cerebral palsy. J Bone Joint Surg Am. 2004. 86-A:2377–2384.
15. Flett PJ, Stern LM, Waddy H, Connell TM, Seeger JD, Gibson SK. Botulinum toxin A versus fixed cast stretching for dynamic calf tightness in cerebral palsy. J Paediatr Child Health. 1999. 35:71–77.
Article
16. Ackman JD, Russman BS, Thomas SS, Buckon CE, Sussman MD, Masso P, et al. Comparing botulinum toxin A with casting for treatment of dynamic equinus in children with cerebral palsy. Dev Med Child Neurol. 2005. 47:620–627.
17. Bottos M, Benedetti MG, Salucci P, Gasparroni V, Giannini S. Botulinum toxin with and without casting in ambulant children with spastic diplegia: a clinical and functional assessment. Dev Med Child Neurol. 2003. 45:758–762.
Article
18. Booth MY, Yates CC, Edgar TS, Bandy WD. Serial casting vs combined intervention with botulinum toxin A and serial casting in the treatment of spastic equinus in children. Pediatr Phys Ther. 2003. 15:216–220.
Article
19. Bohannon RW, Smith MB. Interrater reliability of a modified Ashworth scale of muscle spasticity. Phys Ther. 1987. 67:206–207.
Article
20. Mackey AH, Walt SE, Lobb G, Stott NS. Intraobserver reliability of the modified Tardieu scale in the upper limb of children with hemiplegia. Dev Med Child Neurol. 2004. 46:267–272.
Article
21. Russell DJ, Avery LM, Rosenbaum PL, Raina PS, Walter SD, Palisano RJ. Improved scaling of the gross motor function measure for children with cerebral palsy: evidence of reliability and validity. Phys Ther. 2000. 80:873–885.
Article
22. Russell DJ. Gross motor function measure (GMFM-66 and GMFM-88) user's manual. 2002. London: Mac Keith Press.
23. Koman LA, Mooney JF 3rd, Smith BP, Goodman A, Mulvaney T. Management of spasticity in cerebral palsy with botulinum-A toxin: report of a preliminary, randomized, double-blind trial. J Pediatr Orthop. 1994. 14:299–303.
Article
24. Jain S, Mathur N, Joshi M, Jindal R, Goenka S. Effect of serial casting in spastic cerebral palsy. Indian J Pediatr. 2008. 75:997–1002.
Article
25. Blackmore AM, Boettcher-Hunt E, Jordan M, Chan MD. A systematic review of the effects of casting on equinus in children with cerebral palsy: an evidence report of the AACPDM. Dev Med Child Neurol. 2007. 49:781–790.
26. Kelly B, MacKay-Lyons MJ, Berryman S, Hyndman J, Wood E. Assessment protocol for serial casting after botulinum toxin a injections to treat equinus gait. Pediatr Phys Ther. 2008. 20:233–241.
Full Text Links
  • YMJ
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr