 |
 |
 |
 |
 |
Subject: Comparison of BTX and Casting for Equinus (AACPDM Report) Date: 9/14/2002 E-MOVE reports from the 56th Annual Meeting of the American Academy of Cerebral Palsy and Developmental Medicine, held in New Orleans September 11-14 2002. Session numbers and pages refer to abstracts published in Developmental Medicine and Child Neurology 2002;44(supplement 91).1. Comparison of botulinum toxin A and casting for treatment of dynamic equinus during gait: Preliminary results B Russman, J Ackman, SS Thomas, C Buckon, P Masso, J Sanders, J D'Astous B4; 8 Botulinum toxin alone is not as effective as casting for treatment of dynamic equinus during gait, according to this study. Thirty-seven children with dynamic equinus were randomized to receive either BTX-A plus casting, placebo plus casting, or BTX-A alone. The dose used was 4 U Botox/kg, injected into the gastrocnemius muscle either unilaterally (for hemiplegia) or bilaterally (for diplegia). Injections were performed at baseline, 3 months, and 6 months, and casts were applied and left in place for 3 weeks following injection. Assesments were performed at 3, 6, 7.5, and 12 months. No significant between-group differences were found on either primary outcome measures (gait parameters and ankle kinematics) or secondary measures (ankle kinetics, range of motion, strength, and muscle tone). There was no increase in walking velocity over baseline in any of the 3 groups. Ankle kinematics and spasticity improved in the BTX plus casting group at 3 months and were maintained throughout the study, while these measures improved in the placebo plus casting group at 7.5 months. The BTX-only group showed no significant improvements at any time point. 2. Efficacy of botulinum toxin type A, serial casting, and combined treatment: A retrospective analysis A Glanzman, H Kim, T Beck, K Swaminathan SP7; 33 BTX-A is less effective than serial casting for increasing the range of motion at the ankle, and does not improve results versus casting alone, according to this retrospective study. Of 86 legs treated for spasticity in 55 patients, 37 received BTX-A, 17 received serial casting, and 32 received a combination. Average dose of BTX-A was 2.5 U Botox/kg. An average of 2.8 casts were applied for 1 week each. Mean improvement in range of motion was 5.1 degrees for BTX-A alone, versus 14.9 degrees for casting alone (p=0.0001), and 17.5 degrees for combination treatment (p=0.0002). The difference between casting alone and combination treatment was not significant. -- 2002 E-MOVE conference reports are made possible in part through unrestricted educational grants from Elan Pharmaceuticals, Glaxo SmithKline, and Pharmacia Corporation. E-MOVE Editor: Richard Robinson, NASW, WE MOVE
|
|
| All contents copyright © WE MOVE 2010. This page last modified 2/25/2009. | |