Effects of botulinum toxin A and/or bimanual task-oriented therapy on upper extremity impairments in unilateral Cerebral Palsy: An explorative study
| Autor: | Eugene Rameckers, Anke Defesche, Rob J. E. M. Smeets, Pieter Leffers, Bjorn Winkens, Lucianne Speth, Jules G. Becher, Yvonne J M Janssen-Potten, Johan S.H. Vles |
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| Přispěvatelé: | RS: CAPHRI School for Public Health and Primary Care, RS: CAPHRI - R3 - Functioning, Participating and Rehabilitation, RS: CAPHRI - R5 - Optimising Patient Care, RS: CAPHRI - R6 - Promoting Health & Personalised Care, RS: MHeNs - R1 - Cognitive Neuropsychiatry and Clinical Neuroscience, Revalidatiegeneeskunde, Epidemiologie, FHML Methodologie & Statistiek, MOVE Research Institute, Rehabilitation medicine |
| Rok vydání: | 2015 |
| Předmět: |
Male
Bimanual Functional training medicine.medical_specialty Upper extremity CHILDREN HAND Thumb INTENSIVE THERAPY Functional therapy Botulinum toxin a Cerebral palsy Grip strength Physical medicine and rehabilitation SPASTIC HEMIPLEGIA medicine Humans Spasticity Botulinum Toxins Type A Range of Motion Articular Botulinum toxin A VALIDITY Child Cerebral Palsy General Medicine medicine.disease Combined Modality Therapy Exercise Therapy body regions medicine.anatomical_structure Neuromuscular Agents Muscle Spasticity RELIABILITY Pediatrics Perinatology and Child Health Physical therapy Female TRIAL Strength Neurology (clinical) Spastic hemiplegia medicine.symptom MOTOR Range of motion Psychology INTERVENTION |
| Zdroj: | European Journal of Paediatric Neurology, 19(3), 337-348. ELSEVIER SCI LTD European Journal of Paediatric Neurology, 19(3), 337-348. W.B. Saunders Ltd Speth, L, Janssen-Potten, Y, Leffers, P, Rameckers, E, Defesche, A, Winkens, B, Becher, J G, Smeets, R & Vles, J 2015, ' Effects of botulinum toxin A and/or bimanual task-oriented therapy on upper extremity impairments in unilateral Cerebral Palsy: An explorative study ', European Journal of Paediatric Neurology, vol. 19, no. 3, pp. 337-348 . https://doi.org/10.1016/j.ejpn.2015.01.004 |
| ISSN: | 1090-3798 |
| DOI: | 10.1016/j.ejpn.2015.01.004 |
| Popis: | OBJECTIVE: This study reports on the effects of botulinum toxin A (BoNT-A) injections in the upper extremity (UE) of children with unilateral Cerebral Palsy (uCP) combined with bimanual task oriented therapy (BITT) or either treatment modality performed separately on UE range of motion (ROM), spasticity and (functional) strength.METHODS: Thirty-five children, mean age 7.14 years (SD 2.63) of whom 11 had a Manual Ability Classification Score (MACS) I, 15 MACS II and 9 MACS III, participated. The trial started with four study groups: BoNT-A-only (n = 5), BITT-only (n = 11), BoNT-A + BITT (n = 13), and control (n = 6). Twenty-two children were randomized and, due to recruitment problems 13 children received their parents' preferred treatment: BoNT-A + BITT or BITT-only. Three comparisons were analysed: BITT (BoNT-A + BITT and BITT-only; n = 24) versus no BITT (BoNT-A-only and control; n = 11), BoNT-A (BoNT-A-only and BoNT-A + BITT; n = 18) versus no BoNT-A (BITT-only and control; n = 17), and the additional effect of BoNT-A (BoNT-A + BITT versus BITT-only).RESULTS: BoNT-A significantly decreased key grip strength and finger flexion tone, had a clinically relevant (additional) positive effect on active thumb abduction and supination and a significantly negative effect on unilateral functional strength. BITT + BoNT-A significantly increased active supination. BITT reduced elbow flexor tone and BITT-only resulted in more improvement than BoNT-A + BITT in functional unimanual and, to a lesser extent, in bimanual grip strength.CONCLUSIONS: In comparison with BoNT-A + BITT, BITT-only gives more improvement on functional grip strength and, therefore, could possibly increase bimanual performance. In this case, the (additional) role of BoNT-A may be an increase in active supination and thumb abduction. |
| Databáze: | OpenAIRE |
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