Sonographic and clinical effects of botulinum toxin Type A combined with extracorporeal shock wave therapy on spastic muscles of children with cerebral palsy. (3rd April 2017)

• Record Type: Journal Article
• Authors: Picelli, Alessandro; La Marchina, Elisabetta; Gajofatto, Francesca; Pontillo, Angelo; Vangelista, Antonella; Filippini, Roberto; Baricich, Alessio; Cisari, Carlo; Smania, Nicola
• Is Part Of: Developmental neurorehabilitation. Volume 20:Number 3(2017)
• Page Start: 160
• Page End: 164
• Publication Date: 2017-04-03
• Subjects: Elasticity imaging techniques -- high-energy shock waves -- physical therapy modalities -- ultrasonography; Children with disabilities -- Rehabilitation -- Periodicals; Developmentally disabled children -- Rehabilitation -- Periodicals; 615.542
• DOI: 10.3109/17518423.2015.1105320
• Languages: English
• ISSNs: 1751-8423

Abstract

ABSTRACT: Objective : The aim of this study was to compare the combined sonographic and clinical effects of botulinum toxin type A (BoNT-A) and extracorporeal shock wave therapy (ESWT) versus BoNT-A alone in children with cerebral palsy. Methods : Ten children with spastic cerebral palsy were randomly assigned to one of two groups. Group 1 received BoNT-A injection into the spastic muscles of the affected limbs plus three ESWT sessions. Group 2 received BoNT-A alone. Assessment was performed before and 1 month after injection. Sonographic outcomes were injected muscles echo intensity and their hardness percentage, and clinical outcomes the modified Ashworth scale and the Tardieu scale. Results : At 1-month evaluation, significant differences in the injected muscles percentage of hardness ( P = 0.021) and the modified Ashworth scale ( P = 0.001) were found between groups. Conclusions : Our results support the hypothesis that the combined effects of BoNT-A and ESWT derive from their respective action on neurological and non-neural rheological components in spastic muscles.