This journal only 2004, Number 1 Rev Mex Med Fis Rehab 2004; 16 (1) Utility of the botulinum toxin in the improvement of the spastic hand in paediatric patients with cerebral palsy Castillo MM, del Valle CMG, Morales OMG, Arellano SME, León HSR Full text How to cite this article Language: Spanish References: 12 Page: 18-22 PDF size: 53.07 Kb. Key words: Spastic hand, botulinum toxin, spasticity, cerebral palsy, hemiparetic, children. ABSTRACT Introduction: The cerebral palsy (CP) is the most common cause of physical handicap in children, with an incidence of 2 to 2.5 per 1,000 newborns. Is the first place in demand of attention in the area of Paediatric Rehabilitation. Objective:To evaluate the functional improvement in spastic hand with application of botulinum toxin A (BTX-A) in children with CP. Methodology: There are two experimental groups. An experimental, longitudinal and prospective study was realized. The A Group as a experimental group and B Group as a control, a total of 40 patients with hemiparetic spastic CP. An initial evaluation and two subsequent evaluations were performed. The mobility arc was measured, graduation in the scale of Ashworth. Both groups were evaluated with Functional Independence Measurement Scale in the child (WeeFIM). BTX-A in doses from 0.5 to 2 U/kg was applied to A Group, in 2 or 3 muscles. B group serves as control. Both groups received Physical and Occupational Therapy. Results: The obtained results of the application of the WeeFIM showed in the third evaluation, the A group obtained an average of 97.90, with a standard deviation of 9.33, B group obtained an average of 97.00, with a standard deviation of 7.34. These results indicate that there is not statistical significant difference between the experimental group and the control group. Conclusions: We found clinical improvement in both groups, but there is not statistical significant difference between the experimental group and the control group, so this study required the more following time. REFERENCES — Barnes KJ. Relationship of upper extremity weight bearing to hand skills of boys with Cerebral Palsy. The Occupational Therapy Journal of Research 1989; 9: 143-154. — Bohannon RW. Interrater Reliabitity of a modified Ashworth scale of muscle spasticity. Physical Therapy 1987; 67: 206-207. — Boradic GE, Ferrante R. Effects of repeated botulinum toxin injections on orbicularis oculi muscle. J Clin Neuro-ophthalmol 1992; 12: 121-127. — Carr LJ, Cosgrove AP, Gringras P, Neville BGR. Position paper on the use of botulinum toxin in cerebral palsy. Arch Dis Child 1998; 79: 271-273. — Corry IS, Cosgrove AP, Duffy CM. Botulinum Toxin A compared with stretching casts in the treatment of the spastic equinus: A randomized prospective trial. 1998; 18: 304-11. — Denisli M, Meh D. Botulinum toxin in the treatment of Cerebral Palsy. Neuropediatrics 1995; 26: 249-252. — Erbguth FJ, Naumann M. Historical aspects of botulinum toxin. Justinus Kerner (1786-1862) and the “sausage poison”. Neurology 1999; 53: 1850-1853. — Fehlings D. An evaluation of botulinum-A toxin injections to improve upper extremity function in children with hemiplegic cerebral palsy. J Pediatrics 2000; 137: 1-10. — 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. — Friedman A. Effects of botulinum toxin A on upper limb spasticity in children with cerebral palsy. Am J Phys Med Rehabil 2000; 79: 53- 59. — Haley SM, Coster WJ. A Content Validity Study of the Pediatric Evaluation of Disability Inventory. Pediatric Physical Therapy 1991; 3:177-184. — Herrera GA, Pérez FF, Flores JM, Gómez GA, Godoy RA. Tratamiento de la espasticidad con toxina botulínica en la parálisis cerebral infantil. Rehabilitación (Madr) 1999; 33: 304-309.