Author/Editor		Hesse, S; Brandl-Hesse, B; Seidel, U; Doll, B; Gregorič, M
Title		Lower limb muscle activity in ambulatory children with cerebral palsy before and after treatment with Botulinum toxin A
Type		članek
Source		Restor Neurol Neuros
Vol. and No.		Letnik 17
Publication year		2000
Volume		str. 1-8
Language		eng
Abstract		Purpose: The study investigated the effect of Botulinum toxin A on the gait and lower limb muscle activity of ambulatory CP children. Methods: 19 spastic diplegic and 4 left hemiparetic CP children were injected with a mean dose of 23.5 units of Botulinum toxin A/kg body weight into the gastrocnemius and hamstring muscles. Muscle tone and gait analysis including the kinesiological electromyogram of the shank and thigh muscles were assessed before and four weeks after injection and compared with the help of a multivariate analysis (p<0.05). Results: Botulinum toxin A caused a definite reduction of plantaflexor, knee and hip hypertonia in 21 children, resulting in a more plantar grade and erect gait in 17 children four weeks after injection. Gait analysis showed a statistically significant improvement in peak ankle dorsiflexion and knee extension during stance, and length of the force point of action under both feet increased. Electromyography revealed significantly less co-contraction of the lower leg muscles, due to a more phasic instead of a tonic activity of the tibialis anterior muscle, and an improved activation pattern of the left rectus and biceps femoris muscles. Conclusions: The present study demonstrated that the injection of Botulinum toxin A resulted in a more mature muscle activation pattern of CP children. Most of the children walked more plantigrade and erect, the functional gait parameters, however, did not change.
Descriptors		CEREBRAL PALSY BOTULINUM TOXIN TYPE A MUSCLE SPASTICITY GAIT CHILD ELECTROMYOGRAPHY MUSCLE, SKELETAL LEG