%0 Journal Article %1 Ackman2005 %A Ackman, Jeffrey D %A Russman, Barry S %A Thomas, Susan Sienko %A Buckon, Cathleen E %A Sussman, Michael D %A Masso, Peter %A Sanders, James %A D'Astous, Jacques %A Aiona, Michael D %A Group, Shriners Hospitals BTX-A Study %D 2005 %J Dev Med Child Neurol %K Ankle Joint; Biomechanics; Botulinum Toxin Type A; Casts, Surgical; Cerebral Palsy; Child; Child, Preschool; Clubfoot; Combined Modality Therapy; Double-Blind Method; Female; Follow-Up Studies; Gait; Humans; Injections, Intramuscular; Male; Prospective Treatment Outcome %N 9 %P 620--627 %T Comparing botulinum toxin A with casting for treatment of dynamic equinus in children with cerebral palsy. %V 47 %X The purpose of this study was to compare the cumulative efficacy (three treatment sessions) of botulinum toxin A (BTX-A) alone, casting alone, and the combination of BTX-A and casting in the management of dynamic equinus in ambulatory children with spastic cerebral palsy (CP). Thirty-nine children with spastic CP (mean age 5y 10mo, range 3 to 9y) were enrolled in the study. A multicenter, randomized, double blind, placebo-controlled prospective study was used. Children were randomly assigned to one of three treatment groups: BTX-A only (B), placebo injection plus casting (C), or BTX-A plus casting (B+C). The dosage for the BTX-A injections was 4U/kg per extremity. Assessments were performed at baseline, 3, 6, 7.5, and 12 months with a total of three treatments administered after the evaluations at baseline, 3, and 6 months. Primary outcome measures were ankle kinematics, velocity, and stride length. Secondary outcome measures were ankle spasticity, strength, range of motion, and ankle kinetics. Group B made no significant change in any variable at any time. Groups C and B+C demonstrated significant improvements in ankle kinematics, spasticity, passive range of motion, and dorsiflexor strength. Results of this 1-year study indicate that BTX-A alone provided no improvement in the parameters measured in this study, while casting and BTX-A/casting were effective in the short- and long-term management of dynamic equinus in children with spastic CP.

@article{Ackman2005, abstract = {The purpose of this study was to compare the cumulative efficacy (three treatment sessions) of botulinum toxin A (BTX-A) alone, casting alone, and the combination of BTX-A and casting in the management of dynamic equinus in ambulatory children with spastic cerebral palsy (CP). Thirty-nine children with spastic CP (mean age 5y 10mo, range 3 to 9y) were enrolled in the study. A multicenter, randomized, double blind, placebo-controlled prospective study was used. Children were randomly assigned to one of three treatment groups: BTX-A only (B), placebo injection plus casting (C), or BTX-A plus casting (B+C). The dosage for the BTX-A injections was 4U/kg per extremity. Assessments were performed at baseline, 3, 6, 7.5, and 12 months with a total of three treatments administered after the evaluations at baseline, 3, and 6 months. Primary outcome measures were ankle kinematics, velocity, and stride length. Secondary outcome measures were ankle spasticity, strength, range of motion, and ankle kinetics. Group B made no significant change in any variable at any time. Groups C and B+C demonstrated significant improvements in ankle kinematics, spasticity, passive range of motion, and dorsiflexor strength. Results of this 1-year study indicate that BTX-A alone provided no improvement in the parameters measured in this study, while casting and BTX-A/casting were effective in the short- and long-term management of dynamic equinus in children with spastic CP.}, added-at = {2014-07-19T17:35:55.000+0200}, author = {Ackman, Jeffrey D and Russman, Barry S and Thomas, Susan Sienko and Buckon, Cathleen E and Sussman, Michael D and Masso, Peter and Sanders, James and D'Astous, Jacques and Aiona, Michael D and Group, Shriners Hospitals BTX-A Study}, biburl = {https://www.bibsonomy.org/bibtex/233f4b7fadd03ba4f8d8dddfc901ffc40/ar0berts}, groups = {public}, interhash = {0d56aca50c43c6e1e958aefcc971c47d}, intrahash = {33f4b7fadd03ba4f8d8dddfc901ffc40}, journal = {Dev Med Child Neurol}, keywords = {Ankle Joint; Biomechanics; Botulinum Toxin Type A; Casts, Surgical; Cerebral Palsy; Child; Child, Preschool; Clubfoot; Combined Modality Therapy; Double-Blind Method; Female; Follow-Up Studies; Gait; Humans; Injections, Intramuscular; Male; Prospective Treatment Outcome}, month = Sep, number = 9, pages = {620--627}, pmid = {16138670}, timestamp = {2014-07-19T17:35:55.000+0200}, title = {Comparing botulinum toxin A with casting for treatment of dynamic equinus in children with cerebral palsy.}, username = {ar0berts}, volume = 47, year = 2005 }