%0 Journal Article %1 Kawamura2007 %A Kawamura, Anne %A Campbell, Kent %A Lam-Damji, Sophie %A Fehlings, Darcy %D 2007 %J Dev Med Child Neurol %K Arm; Botulinum Toxin Type A; Brain Damage, Chronic; Cerebral Palsy; Child; Child, Preschool; Dose-Response Relationship, Drug; Double-Blind Method; Female; Hemiplegia; Humans; Injections, Intramuscular; Male; Motor Skills; Muscle Spasticity; Strength; Tonus; Muscle, Skeletal; Neurologic Examination %N 5 %P 331--337 %R 10.1111/j.1469-8749.2007.00331.x %T A randomized controlled trial comparing botulinum toxin A dosage in the upper extremity of children with spasticity. %U http://dx.doi.org/10.1111/j.1469-8749.2007.00331.x %V 49 %X This study compared the effects of low and high doses of botulinum toxin A (BTX-A) to improve upper extremity function. Thirty-nine children (22 males, 17 females) with a mean age of 6 years 2 months (SD 2y 9mo) diagnosed with spastic hemiplegia or triplegia were enrolled into this double-blind, randomized controlled trial. The high-dose group received BTX-A in the following doses: biceps 2U/kg, brachioradialis 1.5U/kg, common flexor origin 3U/kg, pronator teres 1.5U/kg, and adductor/opponens pollicis 0.6U/kg to a maximum of 20U. The low-dose group received 50\% of this dosage. Outcomes were measured at baseline and at 1 and 3 months after injection, and results were analyzed with a repeated-measures analysis of variance. There was no significant difference between the low-dose and high-dose groups in upper extremity function over the 3-month period as measured by the Quality of Upper Extremity Skills Test (F1,37=0.18, p=0.68). There was no difference between the groups in the Pediatric Evaluation of Disability Inventory Self Care Domain (F1,37=0.05, p=0.83). Although grip strength decreased over the 3-month period, there was no difference between groups (F1,32=0.45, p=0.51). These findings indicate that there is no difference in hand and arm function between a low dose and a high dose of BTX-A at 1 and 3 months after injection. This information can be used to guide dosage of BTX-A for the management of upper extremity spasticity in children.

@article{Kawamura2007, abstract = {This study compared the effects of low and high doses of botulinum toxin A (BTX-A) to improve upper extremity function. Thirty-nine children (22 males, 17 females) with a mean age of 6 years 2 months (SD 2y 9mo) diagnosed with spastic hemiplegia or triplegia were enrolled into this double-blind, randomized controlled trial. The high-dose group received BTX-A in the following doses: biceps 2U/kg, brachioradialis 1.5U/kg, common flexor origin 3U/kg, pronator teres 1.5U/kg, and adductor/opponens pollicis 0.6U/kg to a maximum of 20U. The low-dose group received 50\% of this dosage. Outcomes were measured at baseline and at 1 and 3 months after injection, and results were analyzed with a repeated-measures analysis of variance. There was no significant difference between the low-dose and high-dose groups in upper extremity function over the 3-month period as measured by the Quality of Upper Extremity Skills Test (F[1,37]=0.18, p=0.68). There was no difference between the groups in the Pediatric Evaluation of Disability Inventory Self Care Domain (F[1,37]=0.05, p=0.83). Although grip strength decreased over the 3-month period, there was no difference between groups (F[1,32]=0.45, p=0.51). These findings indicate that there is no difference in hand and arm function between a low dose and a high dose of BTX-A at 1 and 3 months after injection. This information can be used to guide dosage of BTX-A for the management of upper extremity spasticity in children.}, added-at = {2014-07-19T20:33:01.000+0200}, author = {Kawamura, Anne and Campbell, Kent and Lam-Damji, Sophie and Fehlings, Darcy}, biburl = {https://www.bibsonomy.org/bibtex/2309873da0ada5bde74051029ed77636c/ar0berts}, doi = {10.1111/j.1469-8749.2007.00331.x}, groups = {public}, interhash = {03e6a0c20d185e2645fac34de5c34dbd}, intrahash = {309873da0ada5bde74051029ed77636c}, journal = {Dev Med Child Neurol}, keywords = {Arm; Botulinum Toxin Type A; Brain Damage, Chronic; Cerebral Palsy; Child; Child, Preschool; Dose-Response Relationship, Drug; Double-Blind Method; Female; Hemiplegia; Humans; Injections, Intramuscular; Male; Motor Skills; Muscle Spasticity; Strength; Tonus; Muscle, Skeletal; Neurologic Examination}, month = May, number = 5, pages = {331--337}, pii = {DMCN331}, pmid = {17489805}, timestamp = {2014-07-19T20:35:08.000+0200}, title = {A randomized controlled trial comparing botulinum toxin A dosage in the upper extremity of children with spasticity.}, url = {http://dx.doi.org/10.1111/j.1469-8749.2007.00331.x}, username = {ar0berts}, volume = 49, year = 2007 }