The Effect and Complication of Botulinum Toxin Type A Injection with Serial Casting for the Treatment of Spastic Equinus Foot
Annals of Rehabilitation Medicine
; : 344-353, 2011.
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| ID: wpr-113066
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ABSTRACT
OBJECTIVE: To identify the effect of serial casting combined with Botulinum toxin type A (BTX-A) injection on spastic equinus foot. METHOD: Twenty-nine children with cerebral palsy who had equinus foot were recruited from the outpatient clinic of Rehabilitation Medicine. The children were divided into 2 groups, one of which received serial casting after BTX-A injection, and the other which only received BTX-A injection. Serial casting started 3 weeks after the BTX-A injection, and was changed weekly for 3 times. Spasticity of the ankle joint was evaluated using the modified Ashworth scale (MAS), and the modified Tardieu scale (MTS). Gait pattern was measured using the physician's rating scale (PRS). RESULTS: The degree of ankle dorsiflexion and the MAS improved significantly until 12 weeks following the BTX-A injection in the serial casting group (p<0.001), while the BTX-A injection-only group improved until 6 weeks following injection (p<0.05). The combined group showed a significantly greater increase in the degree of dorsiflexion compared to the BTX-A injection-only group at post-injection weeks 6 and 12 (p<0.05). Three children (11.5%) suffered from foot ulcers as a complication caused by the serial casting. CONCLUSION: Our study demonstrated that the effect of BTX-A injection with serial casting was superior and lasted longer than the effect of BTX-A injection only in patients with spastic equinus foot. We therefore recommend BTX-A injection with serial casting for the treatment of equinus foot. However, physicians must also consider the possible complications associated with serial casting.
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Índice:
WPRIM
Asunto principal:
Toxinas Botulínicas
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Parálisis Cerebral
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Úlcera del Pie
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Toxinas Botulínicas Tipo A
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Instituciones de Atención Ambulatoria
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Pie
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Marcha
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Tobillo
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Articulación del Tobillo
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Espasticidad Muscular
Límite:
Animals
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Humans
Idioma:
En
Revista:
Annals of Rehabilitation Medicine
Año:
2011
Tipo del documento:
Article