%0 Journal Article %1 Scholtes2007 %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 2007 %J Pediatr Neurol %K , Neurologic; Botulinum Toxin Type A; Cerebral Palsy; Child; Child, Preschool; Combined Modality Therapy; Female; Gait; Gait Disorders; Humans; Knee Joint; Male; Muscle Contraction; Spasticity; Neuromuscular Agents; Treatment Outcome %N 1 %P 30--39 %R 10.1016/j.pediatrneurol.2006.09.010 %T Effect of multilevel botulinum toxin a and comprehensive rehabilitation on gait in cerebral palsy. %U http://dx.doi.org/10.1016/j.pediatrneurol.2006.09.010 %V 36 %X To evaluate the effect of multilevel botulinum toxin A and comprehensive rehabilitation on gait pattern, muscle length, and spasticity, a multicenter randomized trial was performed in 46 children with spastic cerebral palsy who walk with flexed knees. Their mean age was 8.0 years (range 4 to 11 years). They were randomly allocated to the intervention group (multilevel botulinum toxin A and comprehensive rehabilitation) or the control group (usual care). After 6 weeks, a significant treatment effect in the intervention group was observed on: improved knee extension during midstance and terminal swing (7 degrees and 5 degrees , P < 0.01, respectively); hip rotation during terminal swing (4 degrees , P = 0.02); gait score (1.7, P < 0.01); decreased spasticity in hamstrings (11 degrees , P < 0.01), gastrocnemius (6 degrees , P = 0.01), and soleus (5 degrees , P = 0.02); and increased muscle length in hamstrings (9 degrees , P < 0.01) and gastrocnemius (5 degrees , P < 0.01). The improved muscle length was maintained up to 24 weeks. This study demonstrated that multilevel botulinum toxin A and comprehensive rehabilitation improves knee extension during gait, increases muscle length, and decreases spasticity in injected muscles after 6 weeks in children who walk with flexed knees. Although the effect on muscle length was maintained after 24 weeks, the effect on gait and spasticity had disappeared.

@article{Scholtes2007, abstract = {To evaluate the effect of multilevel botulinum toxin A and comprehensive rehabilitation on gait pattern, muscle length, and spasticity, a multicenter randomized trial was performed in 46 children with spastic cerebral palsy who walk with flexed knees. Their mean age was 8.0 years (range 4 to 11 years). They were randomly allocated to the intervention group (multilevel botulinum toxin A and comprehensive rehabilitation) or the control group (usual care). After 6 weeks, a significant treatment effect in the intervention group was observed on: improved knee extension during midstance and terminal swing (7 degrees and 5 degrees , P < 0.01, respectively); hip rotation during terminal swing (4 degrees , P = 0.02); gait score (1.7, P < 0.01); decreased spasticity in hamstrings (11 degrees , P < 0.01), gastrocnemius (6 degrees , P = 0.01), and soleus (5 degrees , P = 0.02); and increased muscle length in hamstrings (9 degrees , P < 0.01) and gastrocnemius (5 degrees , P < 0.01). The improved muscle length was maintained up to 24 weeks. This study demonstrated that multilevel botulinum toxin A and comprehensive rehabilitation improves knee extension during gait, increases muscle length, and decreases spasticity in injected muscles after 6 weeks in children who walk with flexed knees. Although the effect on muscle length was maintained after 24 weeks, the effect on gait and spasticity had disappeared.}, 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/29873476b9b25baed5601790c9c682fda/ar0berts}, doi = {10.1016/j.pediatrneurol.2006.09.010}, groups = {public}, interhash = {a3171234d90e4a714ebf47994c63a894}, intrahash = {9873476b9b25baed5601790c9c682fda}, journal = {Pediatr Neurol}, keywords = {, Neurologic; Botulinum Toxin Type A; Cerebral Palsy; Child; Child, Preschool; Combined Modality Therapy; Female; Gait; Gait Disorders; Humans; Knee Joint; Male; Muscle Contraction; Spasticity; Neuromuscular Agents; Treatment Outcome}, month = Jan, number = 1, pages = {30--39}, pii = {S0887-8994(06)00572-8}, pmid = {17162194}, timestamp = {2014-07-19T21:17:37.000+0200}, title = {Effect of multilevel botulinum toxin a and comprehensive rehabilitation on gait in cerebral palsy.}, url = {http://dx.doi.org/10.1016/j.pediatrneurol.2006.09.010}, username = {ar0berts}, volume = 36, year = 2007 }