%0 Journal Article %1 Scholtes2006 %A Scholtes, Vanessa A %A Dallmeijer, Annet J %A Knol, Dirk L %A Speth, Lucianne A %A Maathuis, Carel G %A Jongerius, Peter H %A Becher, Jules G %D 2006 %J Arch Phys Med Rehabil %K Botulinum Toxin Type A; Cerebral Palsy; Child; Child, Preschool; Combined Modality Therapy; Disability Evaluation; Female; Humans; Male; Mobility Limitation; Neuromuscular Agents; Physical Therapy Modalities; Time Factors; Treatment Outcome %N 12 %P 1551--1558 %R 10.1016/j.apmr.2006.08.342 %T The combined effect of lower-limb multilevel botulinum toxin type a and comprehensive rehabilitation on mobility in children with cerebral palsy: a randomized clinical trial. %U http://dx.doi.org/10.1016/j.apmr.2006.08.342 %V 87 %X OBJECTIVE: To evaluate the combined effect on mobility of treatment with multilevel botulinum toxin type A (BTX-A) and comprehensive rehabilitation in children with cerebral palsy (CP). DESIGN: Randomized clinical trial using a multiple baseline design. The intervention group was treated 6 weeks after randomization. The control group was treated after a longer period of 18 to 30 weeks. Repeated measurements in both groups were continued throughout the process, before and up to 48 weeks after treatment. SETTING: Four departments of rehabilitation medicine in The Netherlands. PARTICIPANTS: Forty-six children with spastic CP (mean age +/- standard deviation, 8.0+/-2.1y). INTERVENTION: The intervention group (n=23) was treated with multilevel BTX-A and comprehensive rehabilitation. Control group subjects (n=23) continued with their usual physical therapy (PT) for 18 to 30 weeks, and then also received multilevel BTX-A and comprehensive rehabilitation. MAIN OUTCOME MEASURES: The primary outcome measure was the Gross Motor Function Measure (GMFM-66); the secondary measures were problem score and energy cost. RESULTS: The treatment effect during the first 24 weeks of follow-up in the intervention group was compared with the effect of usual PT in the control group. Treatment with multilevel BTX-A and comprehensive rehabilitation provided a significantly greater improvement at 12 and 24 weeks in both the GMFM-66 (2.1 points, P=.02; and 3.5 points, P<.01, respectively) and problem score (1.8 and 1.7 points, P<.001, respectively) compared with usual PT. No difference was found in energy cost. Before-after analysis of the total group (n=46) showed a significant long-term improvement (48wk) on all outcome measures. CONCLUSIONS: Treatment with multilevel BTX-A and comprehensive rehabilitation significantly improves mobility as measured by the GMFM-66 and problem score in children with CP.

@article{Scholtes2006, abstract = {OBJECTIVE: To evaluate the combined effect on mobility of treatment with multilevel botulinum toxin type A (BTX-A) and comprehensive rehabilitation in children with cerebral palsy (CP). DESIGN: Randomized clinical trial using a multiple baseline design. The intervention group was treated 6 weeks after randomization. The control group was treated after a longer period of 18 to 30 weeks. Repeated measurements in both groups were continued throughout the process, before and up to 48 weeks after treatment. SETTING: Four departments of rehabilitation medicine in The Netherlands. PARTICIPANTS: Forty-six children with spastic CP (mean age +/- standard deviation, 8.0+/-2.1y). INTERVENTION: The intervention group (n=23) was treated with multilevel BTX-A and comprehensive rehabilitation. Control group subjects (n=23) continued with their usual physical therapy (PT) for 18 to 30 weeks, and then also received multilevel BTX-A and comprehensive rehabilitation. MAIN OUTCOME MEASURES: The primary outcome measure was the Gross Motor Function Measure (GMFM-66); the secondary measures were problem score and energy cost. RESULTS: The treatment effect during the first 24 weeks of follow-up in the intervention group was compared with the effect of usual PT in the control group. Treatment with multilevel BTX-A and comprehensive rehabilitation provided a significantly greater improvement at 12 and 24 weeks in both the GMFM-66 (2.1 points, P=.02; and 3.5 points, P<.01, respectively) and problem score (1.8 and 1.7 points, P<.001, respectively) compared with usual PT. No difference was found in energy cost. Before-after analysis of the total group (n=46) showed a significant long-term improvement (48wk) on all outcome measures. CONCLUSIONS: Treatment with multilevel BTX-A and comprehensive rehabilitation significantly improves mobility as measured by the GMFM-66 and problem score in children with CP.}, added-at = {2014-07-19T21:17:37.000+0200}, author = {Scholtes, Vanessa A and Dallmeijer, Annet J and Knol, Dirk L and Speth, Lucianne A and Maathuis, Carel G and Jongerius, Peter H and Becher, Jules G}, biburl = {https://www.bibsonomy.org/bibtex/296ee1321ce49c9535ce5d4f91ec6a434/ar0berts}, doi = {10.1016/j.apmr.2006.08.342}, groups = {public}, interhash = {2552576e5c4402631491132c074f6dd8}, intrahash = {96ee1321ce49c9535ce5d4f91ec6a434}, journal = {Arch Phys Med Rehabil}, keywords = {Botulinum Toxin Type A; Cerebral Palsy; Child; Child, Preschool; Combined Modality Therapy; Disability Evaluation; Female; Humans; Male; Mobility Limitation; Neuromuscular Agents; Physical Therapy Modalities; Time Factors; Treatment Outcome}, month = Dec, number = 12, pages = {1551--1558}, pii = {S0003-9993(06)01325-6}, pmid = {17141633}, timestamp = {2014-07-19T21:17:37.000+0200}, title = {The combined effect of lower-limb multilevel botulinum toxin type a and comprehensive rehabilitation on mobility in children with cerebral palsy: a randomized clinical trial.}, url = {http://dx.doi.org/10.1016/j.apmr.2006.08.342}, username = {ar0berts}, volume = 87, year = 2006 }