Effect of combined rehabilitation program with botulinum toxin type A injections on gross motor function scores in children with spastic cerebral palsy.
Abeer Flemban, Walaa Elsayed
PMID 30034093WHAT IT FOUND
In children with spastic cerebral palsy, adding two weeks of intensive physiotherapy after botulinum toxin type A, plaster casts and medical shoes was associated with greater gross motor function improvement than the same treatment without physiotherapy.
Key findings
01Group 2 had significantly greater gross motor function score improvement than Group 1 at each assessment.
02Gross motor function scores changed significantly from baseline in Group 2 but not in Group 1.
03No adverse effects were observed or reported during the study.
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How it was doneWhat they foundWhat it means for PTs
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What it does not show
Children were assigned by hospital catchment rather than randomisation, so group differences could reflect factors other than treatment. Both groups received botulinum toxin type A, plaster casts and medical shoes, so the study cannot separate the contribution of any single component. The sample was 46 ambulatory children with spastic diplegia and dynamic equinus, so it may not apply to children with fixed contractures, severe disability or other cerebral palsy patterns. The study measured gross motor function rather than muscle tone, so it does not show how tone changed.
Declared interests
None declared.
The easy way to misread this
Do not conclude that physiotherapy alone caused the greater gross motor function scores. Both groups received botulinum toxin type A, plaster casts and medical shoes, allocation was by hospital catchment rather than randomisation, and the study cannot show that any single component was responsible.