The Effect of Foot Serial Casting Along with Botulinum Toxin Type-A Injection on Spasticity in Children with Cerebral Palsy

Authors

1 PhD Student of Occupational Therapy, Department of Occupational Therapy, University of Social Welfare & Rehabilitation Sciences, Tehran, Iran Pediatric Rehabilitation Research Center, Tehran, Iran

2 PhD Student of Occupational Therapy, Department of Occupational Therapy, University of Social Welfare & Rehabilitation Sciences, Tehran, Iran

3 Assistant Professor, Department of Biostatistics and Epidemiology, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran

4 Associate Professor of Pediatrics Neurology, Faculty of Medicine, Baqiyatallah University of Medical Sciences, Tehran, Iran

5 Pediatric Rehabilitation Research Center, Tehran, Iran Assistant Professor, Department of Occupational Therapy, University of Social Welfare & Rehabilitation Sciences, Tehran, Iran

6 PhD Student of Exercise Physiology, Baqiyatallah University of Medical Sciences, Tehran, Iran Exercise Physiology Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran

Abstract

Background & Aims: The goal of this study was to determine the effect of foot serial casting along with botulinum toxin type-A injection on spasticity in children with cerebral palsy. Methods: This study was a randomized clinical trial performed as a pre-post, double blind study. It was performed on 25 children with hemiplegia and diplegia (2-8 years) in Tehran city, who were referred to valiasr rehabilitation foundation. Participants were chosen by simple randomized sampling and were matched for age, Gross Motor Function Classification System (GMFCS) and type. They were randomly divided into two groups. The first group (n=13) underwent BTX-A injection alone and the second group (n=12) had BTX-A injection and foot serial casting after the injection. Clinical assessments were done using the GMFCS and Modified Ashworth Scale before and at 1, 3, 6 and 12 months after the interventions. Data were analyzed by Wilcoxon signed rank test and mann-whitney U. Results: Comparison of two groups in regard to the right and left knee spasticity at, 1, 3, 6 and 12 months after injection showed no significant difference in comparison to those before interventions. Furthermore, comparison of right and left ankle spasticity before injection with that at 1, and 3 months follow ups did not show statistically significant difference, but significant differences were found when compared with 6 and 12 month follow-ups (P<0.05) Conclusion: It seems, one of the proper approaches to reduce spasticity in children with cerebral palsy is foot serial casting along with botulinum toxin type-A injection and it can decrease the muscle tone when applied more than six months.

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