%0 Journal Article %1 Wissel1999 %A Wissel, J. %A Heinen, F. %A Schenkel, A. %A Doll, B. %A Ebersbach, G. %A M?ller, J. %A Poewe, W. %D 1999 %J Neuropediatrics %K Adolescent; Adult; Botulinum Toxin Type A; Cerebral Palsy; Child; Child, Preschool; Dose-Response Relationship, Drug; Double-Blind Method; Female; Gait; Humans; Injections, Intramuscular; Male; Muscle Spasticity %N 3 %P 120--124 %T Botulinum toxin A in the management of spastic gait disorders in children and young adults with cerebral palsy: a randomized, double-blind study of "high-dose" versus "low-dose" treatment. %V 30 %X The present study was performed to assess dose-response relationships of local botulinum toxin A (BtxA) treatment in children and teenagers with spastic gait due to cerebral palsy (CP) in a randomized, double-blind study employing a "high-dose" (200 units Botox per leg) and a "low-dose" (100 units Botox per leg) treatment arm in 33 patients with CP. Response parameters included changes in muscle tone assessed by the Ashworth scale at knee joint, range-of-motion (ROM) measurements at knee and ankle joint, objective analysis of longitudinal gait parameters as well as subjective assessments of improvement. Patients in the "high-dose" arm received 40-80 units Botox/muscle versus 20-40 units Botox/muscle in the "low-dose" group. Patients in both treatment arms showed significant improvement of Ashworth score (p<0.001) and ROM (p<0.01), while gait analysis revealed significant increase in gait velocity (p<0.01) and stride-length (p<0.001) over baseline. Subjects in the "high-dose" group showed significantly greater improvement on objective response measurements compared to "low-dose" patients. Also, children aged 7 years or less had greater functional benefit compared to the subgroup of patients older than 7 years. Incidence and severity of side-effects were similar in both treatment groups. The present study demonstrated dose-dependent functional improvement of dynamic deformities and spastic gait pattern in children and young adults with CP treated with local injections of botulinum toxin. A dose of 200 units Botox per leg distributed to 4 or 5 muscle bellies per leg is superior compared to 100 units Botox per leg without significantly affecting the risk of side-effects.

@article{Wissel1999, abstract = {The present study was performed to assess dose-response relationships of local botulinum toxin A (BtxA) treatment in children and teenagers with spastic gait due to cerebral palsy (CP) in a randomized, double-blind study employing a "high-dose" (200 units Botox per leg) and a "low-dose" (100 units Botox per leg) treatment arm in 33 patients with CP. Response parameters included changes in muscle tone assessed by the Ashworth scale at knee joint, range-of-motion (ROM) measurements at knee and ankle joint, objective analysis of longitudinal gait parameters as well as subjective assessments of improvement. Patients in the "high-dose" arm received 40-80 units Botox/muscle versus 20-40 units Botox/muscle in the "low-dose" group. Patients in both treatment arms showed significant improvement of Ashworth score (p<0.001) and ROM (p<0.01), while gait analysis revealed significant increase in gait velocity (p<0.01) and stride-length (p<0.001) over baseline. Subjects in the "high-dose" group showed significantly greater improvement on objective response measurements compared to "low-dose" patients. Also, children aged 7 years or less had greater functional benefit compared to the subgroup of patients older than 7 years. Incidence and severity of side-effects were similar in both treatment groups. The present study demonstrated dose-dependent functional improvement of dynamic deformities and spastic gait pattern in children and young adults with CP treated with local injections of botulinum toxin. A dose of 200 units Botox per leg distributed to 4 or 5 muscle bellies per leg is superior compared to 100 units Botox per leg without significantly affecting the risk of side-effects.}, added-at = {2014-07-19T21:56:18.000+0200}, author = {Wissel, J. and Heinen, F. and Schenkel, A. and Doll, B. and Ebersbach, G. and M?ller, J. and Poewe, W.}, biburl = {https://www.bibsonomy.org/bibtex/24a5e5b2df18b2f2cc45004f58a79f7d3/ar0berts}, groups = {public}, interhash = {fbad6ea5ea3bcc5e15e4e2c033aaa94c}, intrahash = {4a5e5b2df18b2f2cc45004f58a79f7d3}, journal = {Neuropediatrics}, keywords = {Adolescent; Adult; Botulinum Toxin Type A; Cerebral Palsy; Child; Child, Preschool; Dose-Response Relationship, Drug; Double-Blind Method; Female; Gait; Humans; Injections, Intramuscular; Male; Muscle Spasticity}, month = Jun, number = 3, pages = {120--124}, pmid = {10480205}, timestamp = {2014-07-19T21:56:18.000+0200}, title = {Botulinum toxin A in the management of spastic gait disorders in children and young adults with cerebral palsy: a randomized, double-blind study of "high-dose" versus "low-dose" treatment.}, username = {ar0berts}, volume = 30, year = 1999 }