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Year : 2018  |  Volume : 32  |  Issue : 3  |  Page : 169-173

Effect of botulinum toxin Type A on various gait parameters in cerebral palsy with lower limb spasticity

1 Department of Physical Medicine and Rehabilitation, All India Institute of Medical Sciences, New Delhi, India
2 Department of Physical Medicine and Rehabilitation, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India

Correspondence Address:
Dr. Abhimanyu Vasudeva
Department of Physical Medicine and Rehabilitation, All India Institute of Medical Sciences, New Delhi
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jms.jms_76_17

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Background: Successful management of spasticity in cerebral palsy (CP) has remained a therapeutic challenge. Botulinum toxin is a potent neuromuscular blocking agent with Type A being commonly used for treating focal spasticity in children with CP. However, its use in CP children is rare in the Indian literature. Research elsewhere has seldom focused on predicting optimal response regarding functional outcome. Objectives: The objective of the study is to study the efficacy of botulinum toxin Type A injection in CP with lower limb spasticity regarding reduction in spasticity, improvement in range of motion (ROM), and improvement in various gait parameters. Study Settings: The study was conducted in the Department of Physical Medicine and Rehabilitation in a tertiary care hospital in North India. Study Design: This was a prospective, interventional cohort study. Methods: Thirty-one children were enrolled in the study. They were evaluated just before injection and at 4 and 12 weeks after injection using Modified Ashworth Scale for gastrocnemius and hamstrings spasticity, Adductor Tone Rating Scale for adductor muscle spasticity and goniometry for ROM of the ankle and knee. Various gait parameters using footprint analysis were also done. Results: Statistically significant reduction was seen in spasticity of gastrocnemius, hamstrings, and hip adductors in the follow-ups at 4 and 12 weeks compared with preintervention (P < 0.05). There was a statistically significant increase in velocity, cadence, stride and step length, and statistically significant reduction in the toe drag in all follow-ups. Conclusion: Botulinum toxin Type A is effective in improving the various gait parameters investigated.

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