[ effect of foot serial casting along with botulinum toxin type-A injection on spasticity in children with cerebral palsy]

ABSTRACT

The goal of this study was to determine the effect of foot serial casting along with botulinum toxin type-A injection on spasticity in children with cerebral palsy. This study was a randomized clinical trial performed as a pre-post, double blind study. It was performed on 25 children with hemiplegia and diplegia [2-8 years] in Tehran city, who were referred to valiasr rehabilitation foundation. Participants were chosen by simple randomized sampling and were matched for age, Gross Motor Function Classification System [GMFCS] and type. They were randomly divided into two groups. The first group [n=13] underwent BTX-A injection alone and the second group [n=12] had BTX-A injection and foot serial casting after the injection. Clinical assessments were done using the GMFCS and Modified Ashworth Scale before and at 1, 3, 6 and 12 months after the interventions. Data were analyzed by Wilcoxon signed rank test and mann-whitney U. Comparison of two groups in regard to the right and left knee spasticity at, 1, 3, 6 and 12 months after injection showed no significant difference in comparison to those before interventions. Furthermore, comparison of right and left ankle spasticity before injection with that at 1, and 3 months follow ups did not show statistically significant difference, but significant differences were found when compared with 6 and 12 month follow-ups [P<0.05] It seems, one of the proper approaches to reduce spasticity in children with cerebral palsy is foot serial casting along with botulinum toxin type-A injection and it can decrease the muscle tone when applied more than six months