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A Journal on Physical Medicine and Rehabilitation after Pathological Events
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Indexed/Abstracted in: CINAHL, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
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European Journal of Physical and Rehabilitation Medicine 2009 December;45(4):501-6
Long lasting benefits following the combination of static night upper extremity splinting with botulinum toxin A injections in cerebral palsy children
Kanellopoulos A. D. 1, Mavrogenis A. F. 1, Mitsiokapa E. A. 2, Panagopoulos D. 1, Skouteli H. 3, Vrettos S. G. 4, Tzanos G. 2, Papagelopoulos P. J. 1
1 First Department of Orthopedics, Athens University Medical School, Athens, Greece;
2 Department of Physical Medicine and Rehabilitation, Thriasio Hospital, Elefsis, Greece;
3 Consultant Pediatric Neurologist, Athens, Greece;
4 Pediatric Physical Therapist, Athens, Greece
AIM: Botulinum toxin A injections and orthotics have been used to manage upper extremity spasticity in hemiplegic children. The authors performed a study to evaluate the necessity and effectiveness of a static night splint following outpatient botulinum toxin A treatment in children with upper limb spastic cerebral palsy.
METHODS: Twenty children with upper limb spastic cerebral palsy were treated with botulinum toxin A injections. A static night splint was applied in half of them. Objective assessment of upper limb function was performed at baseline, at 2 and 6 months after botulinum toxin A injection using the Quality of Upper Extremity Skills Test.
RESULTS: After botulinum toxin A treatment, both groups showed an improvement on their previous functional level of the injected upper extremity. At 2 months, children in group A showed a 15.4% improvement, whereas children in group B improved by 12.2% from baseline; these were not statistically significant (P=0.326). At 6 months, group A still maintained a 15.9% improvement in function compared to group B which differed only by 4.2% from prebotulinum toxin A baseline; these differences were statistically significant (P=0.000). Complica-tions related to the botulinum toxin A injection were not observed. The static CONCLUSIONS: Static night splinting following botulinum toxin A injections has shown a definite treatment effect in reducing spasticity and improving function in children with upper limb spastic cerebral palsy.