Case Report: Combination of focal vibration therapy and botulinum toxin injections to treat equinus gait in a child with unilateral spastic cerebral palsy.
Christophe Boulay, Jacques-Olivier Coq, Morgan Sangeux and 10 others
PMID 39981203WHAT IT FOUND
In one child with cerebral palsy, adding vibration therapy to standard care and botulinum toxin injections was associated with faster walking and less calf pain.
The vibration effects seemed to disappear after the toxin injections, suggesting the two treatments may work through different mechanisms.
Key findings
01Walking speed increased by 0.11 m/sec (12%) over the two-month program, from 0.95 m/sec to 1.06 m/sec.
02Immediate gains in ankle range of motion and reduced resistance from vibration sessions largely disappeared after botulinum toxin injections were administered.
03The child and parents reported a gradual reduction in calf pain as the treatment program progressed.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
This is a single case report, so the results cannot be generalized to other children. The child received conventional physical therapy, vibration therapy, and botulinum toxin injections simultaneously or in sequence, making it impossible to determine which component caused the improvements in walking speed or pain. The study did not follow the child for the full three months typically needed to assess the complete effect of botulinum toxin. There was no control group or blinding, so observer and parent bias may have influenced the assessment of pain and movement.
Declared interests
The authors declared no financial support was received for the research, authorship, or publication.
The easy way to misread this
Do not assume that adding vibration therapy to botulinum toxin injections will provide additive benefits for ankle mobility. In this child, the immediate effects of vibration disappeared once the toxin was injected, suggesting the two treatments may target different physiological pathways or that the toxin alters the muscle's response to vibration.