Advantages of Botulinum Toxin A Treatment in Combination with Controlled Dynamic Stretching Orthotics for the Treatment of Contractures

Background/Purpose: Spasticity appears in 80% of the children with cerebral palsy. Secondary to spasticity, contractures can occur. Botulinum toxin A (BTA) is used to treat spasticity, but not contractures. Therefore BTA is used in combination physical therapy (PT) and casting. Serial casting brings a great benefit in improving the passive range of motion (PROM), it does come with its disadvantages: skin irritations and pain are a common problem. But mostly, no active PT is possible while wearing the cast. With controlled dynamic stretching orthotics active PT is allowed during the most active period of BTA.

We hypothesized that the combination of BTA with CDS orthotics will show greater results in terms of ankle joint PROM than BTA treatment only.

Methods: Group A contained the treatment of calf muscles with BTA in combination with CDS orthotic. Group B contained the treatment of calf muscle with BTA only. Data of both treatment options were retrospectively compared with as primary endpoint PROM of the ankle joint.

Results: Group A showed significant improvements at 1 (median 10° [p = 0.019]) and 3 months (median 10° [p = 0.016]) post-injections. This reduced back to a median 0° (p = 0.152) at 6 months post-injections. No significant changes were found in group B at 1 (median 5° [p = 0.340]), 3 (median 0° [p = 0.453]), or 6 (median −5° [p = 0.353]) months post-injections.

Conclusion: The combinational therapy of BTA with CDS orthotics shows promising results in terms of PROM. This success could mean more comfortable treatment options in the future for children with calf muscle spasticity.

 

Scroll to top

Die Autoren geben an, dass kein Interessenkonflikt besteht.

Publikationsverlauf

Artikel online veröffentlicht:
28. Oktober 2021