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Clinical Rehabilitation, Vol. 20, No. 8, 668-674 (2006)
DOI: 10.1191/0269215506cre985oa
© 2006 SAGE Publications

The effect of botulinum toxin type A injection into the gastrocnemius muscle on sit-to-stand transfer in children with spastic diplegic cerebral palsy

Eun Sook Park

Seodaemun-gu Shinchon-dong 134, Rehabilitation Hospital, Yonsei University College of Medicine, Seoul, Korea, 120-752pes1234{at}yumc.yonsei.ac.kr; Department of Rehabilitation Medicine and Research Institute of Rehabilitation, Yonsei University College of Medicine, Seoul, Korea

Chang Il Park

Hyun Chung Chang

Chan Woo Park

Don Shin Lee

Department of Rehabilitation Medicine and Research Institute of Rehabilitation, Yonsei University College of Medicine, Seoul, Korea

Objective: To investigate the benefit of botulinum toxin type A injection into the ankle plantarflexor muscle on sit-to-stand transfer in children with spastic diplegic cerebral palsy.

Design: Case-control study.

Setting: Inpatients in a university-affiliated hospital.

Subjects: Forty spastic diplegic children aged from 2 to 6 years (18 children with botulinum toxin type A injection into both gastrocnemius muscles as an experimental group and 14 children without injection as a control group).

Main measures: Sit-to-stand transfer task was evaluated using a motion analyser (Vicon 370 MA with six infrared cameras). The tests were performed twice with a two-week interval. The changes in temporal, kinematic and kinetic parameters were investigated in each group.

Results: In the control group there were no significant changes in any of the measured parameters between the tests. In the experimental group, total duration (s) of sit-to-stand transfer was shortened after injection (4.359 ± 2.49 to 2.899 ± 1.48, P < 0.05). The maximal angles (degrees) of pelvic and hip joints were reduced (28.889 ± 5.53 to 26.579 ± 3.73 and 90.789 ± 8.69 to 87.239 ± 8.76) and the initial angle of ankle dorsiflexion was increased (4.419 ± 6.16 to 7.089 ± 6.09) after injection (P < 0.05). The maximal moments (Nm/kg) of the hip and knee joints (0.449 ± 0.17 to 0.519 ± 0.21 and 0.139 ± 0.05 to 0.189 ± 0.14) were increased while that of the ankle joint was reduced (0.329 ± 0.09 to 0.289 ± 0.10) after injection (P < 0.05). Only the cases with greater reduction of spasticity showed an improvement on kinematic and kinetic parameters.

Conclusion: Botulinum toxin type A injection into spastic ankle plantarflexors led to better accomplishment of sit-to-stand transfer in children with spastic diplegic cerebral palsy.


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