Adductor spasticity in children with cerebral palsy (CP) impairs motor function and development. In a placebo-controlled, double-blind, randomized multicentre study, we evaluated the effects of botulinum toxin A(BTX-A) in 61 children (37 males, 24 females; mean age 6 years 1 month [SD 3y 1mo]) with CP (leg-dominated tetraparesis, n=39; tetraparesis, n=22; GMFCS level I, n=3; II, n=6; III, n=17; IV, n=29; V, n=6). Four weeks after treatment, a significant superiority of BTX-A was observed in the primary outcome measure (knee-knee distance 'fast catch', p=0.002), the Ashworth scale (p=0.001), and the Goal Attainment Scale (p=0.037).
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http://dx.doi.org/10.1017/S0012162206000041 | DOI Listing |
Cureus
November 2024
Neurological Surgery, Baylor College of Medicine, Houston, USA.
Background The management of adductor spasticity and long-term sequelae for cerebral palsy (CP) patients is complex. Hip displacement is a common consequence of CP, and obturator neurectomy (ON) is a potentially underutilized procedure to address the underlying adductor spasticity. The aim of this study is to describe the operational technique of ON and highlight the potential efficacy of ON in reducing spasticity, as well as pain, hip, and functional outcomes in these patients.
View Article and Find Full Text PDFBMJ Open
December 2024
Orthopedics and Sports Medicine, Erasmus MC Sophia Children Hospital, Rotterdam, The Netherlands.
Introduction: Up to one-third of patients with cerebral palsy (CP) develop hip migration. Current standard care for early hip migration is bilateral adductor-psoas tenotomy; however, the failure rate is relatively high with 34%-74% of patients with CP requiring secondary hip surgery. Using temporary medial hemiepiphysiodesis of the proximal femur (TMH-PF), the morphology of the hip can be changed.
View Article and Find Full Text PDFIran J Otorhinolaryngol
September 2024
Department of Otorhinolaryngology - Head and Neck Surgery, American University of Beirut Medical Center, Beirut, Lebanon.
Introduction: Adductor Spasmodic Dysphonia (ADSD) is the most common form of spasmodic dysphonia. It encompasses various symptoms affecting voice and speech. The objective of this study is to report the management of patients with ADSD using the transnasal endoscopic approach for laryngeal Botulinum Toxin (Botox) injection.
View Article and Find Full Text PDFBackground Children with cerebral palsy (CP) often experience motor and postural disorders, along with spasticity, muscle weakness, muscle-tendon contractures, and decreased joint range of motion (ROM). Muscle-tendon contractures are typically addressed through orthopaedic surgery to improve joint ROM, which can result in further muscle weakness. This study aimed to investigate the impact of selective percutaneous myofascial lengthening (SPML) combined with functional physiotherapy on joint passive ROM and isometric muscle strength in the lower extremities of children with spastic CP.
View Article and Find Full Text PDFAnat Cell Biol
December 2024
Department of Basic Sciences, College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates.
Spasticity which is focal or segmental such as affecting a single muscle group or limb can be treated by chemical neurolysis or surgical denervation at the neurovascular hilus. This study determines the motor entry points (MEPs) of adductor muscles of the thigh in the adult Indian population and identifies precise anatomical landmarks for the successful performance motor point procedures for the relief of muscle spasticity. A total of 10 adult lower limbs were dissected, and nerve branches to adductor muscles were carefully exposed up to their MEP.
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