Follow-up Study of Motor Point Block by Phenol in Spastic Cerebral Palsy

ABSTRACT

OBJECTIVE: The purposes of this study are to find out the long-term effect of motor point block using phenol on spasticity and gait pattern of spastic cerebral palsy children and to examine contributing factors for success of phenol block in functional implication of cerebral palsy. METHOD: We injected 5% phenol into muscles of 35 cases with spastic cerebral palsy under the electromyographic monitoring. Pre, immediate post, and follow-up evaluations for type and severity, grade of spasticity, range of motion, and gait patterns by locomotion rating scale (LRS) were analyzed. RESULTS: The degree of spasticity was reduced dramatically by block, but this effect returned back to the level of pre-block state on follow-up evaluation. There was much improvement in pes equinus, genu recurvatum and scissoring tendency, while little change was observed in crouch gait and hind foot instability. These effects have been sustained on follow-up evaluation. The gait speed, deviation to normal gait, and instability in walking were significantly improved after block and on follow-up. Maintenance of adequate range of motion and good standing balance were the most important contributing factors determining the success in phenol block. Initial spasticity, initial and post LRS score were not significant. CONCLUSION: After phenol block, spasticity returned back to the level of pre-block state but improvement in locomotion activity was maintained over 8 months on follow-up evaluation. The maintenance of adequate range of motion and good standing balance were the most important contributing factors determining the success in motor point block for improving locomotion activity.