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Cerebral palsy toxin

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https://www.readbyqxmd.com/read/29185676/effect-of-physiotherapeutic-intervention-on-the-gait-after-the-application-of-botulinum-toxin-in-children-with-cerebral-palsy-systematic-review
#1
Paulo R Fonseca, Renata C Franco de Moura, Manuela Galli, Claudia Santos Oliveira
BACKGROUND: Cerebral palsy is a group of movement and posture development disorders. 90% of this population has gait impairment, often due to the presence of spasticity. A number of studies emphasize the importance of combined physical therapy with botulinum toxin A treatment. However, no consensus can be reached concerning the content of the physiotherapy programme after treatment with botulinum toxin A. AIM: The purpose of the present study was to investigate, through a systematic review of the literature, the effects of physiotherapeutic intervention on gait after botulinum toxin application in children with cerebral palsy...
November 29, 2017: European Journal of Physical and Rehabilitation Medicine
https://www.readbyqxmd.com/read/29154085/btx-a-has-notable-effects-contradicting-some-treatment-aims-in-the-rat-triceps-surae-compartment-which-are-not-confined-to-the-muscles-injected
#2
Can A Yucesoy, Filiz Ateş
Botulinum toxin type-A (BTX-A) is widely used in treating gastrocnemius medial (GM) and lateral (GL) muscles in cerebral palsy to improve joint motion. However, recent animal experiments indicate inferior BTX-A effects beyond the injected muscle. The goal was to test the following hypotheses in a rat model. (1) BTX-A injected into the GM and GL does not spread into the soleus (SOL), and muscles exposed show (2) a wider length range of force exertion (Lrange), (3) reduced passive forces and (4) no intermuscular interaction effects...
November 6, 2017: Journal of Biomechanics
https://www.readbyqxmd.com/read/29150297/prolonged-stretching-of-the-ankle-plantarflexors-elicits-muscle-tendon-adaptations-relevant-to-ankle-gait-kinetics-in-children-with-spastic-cerebral-palsy
#3
Teresa Martín Lorenzo, Eduardo Rocon, Ignacio Martínez Caballero, Ana Ramírez Barragán, Sergio Lerma Lara
Tissue related ankle hyper-resistance has been reported to contribute to equinus gait in children with spastic cerebral palsy. Hence, ankle plantarflexor stretching programs have been developed in order to restore passive ankle dorsiflexion. Despite high quality evidence on the limited effects of stretching on passive joint mobility, further muscle-tendon adaptations have been reported which may impact gait performance. As such, children with spastic cerebral palsy subject to long-term manual static stretching achieved dorsiflexion gains through the reduction of muscle and fascicle strain whilst preserving tendon strain, and prolonged use of ankle-foot orthoses achieved similar dorsiflexion gains through increased tendon strain whilst preserving muscle and fascicle strain...
November 2017: Medical Hypotheses
https://www.readbyqxmd.com/read/29146092/ultrasonographic-evaluation-of-changes-in-the-muscle-architecture-of-the-gastrocnemius-with-botulinum-toxin-treatment-for-lower-extremity-spasticity-in-children-with-cerebral-palsy
#4
Akihiro Kawano, Taiichiro Yanagizono, Ichiro Kadouchi, Tetsuya Umezaki, Etsuo Chosa
BACKGROUND: Botulinum toxin A treatment involves injecting botulinum toxin A to relax muscle spasticity. Using ultrasonography, this study examined changes in the muscle architecture before and after treatment to evaluate the influence of botulinum toxin A injection on muscles. METHODS: The participants included 18 children (mean age, 6.2 years) with cerebral palsy who were treated with botulinum toxin A for lower extremity spasticity and 27 healthy children (mean age, 6...
November 13, 2017: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
https://www.readbyqxmd.com/read/29145580/effect-of-botulinum-toxin-a-on-muscle-healing-and-its-implications-in-aesthetic-and-reconstructive-surgery
#5
Eldad Silberstein, Ehud Maor, Oleg Sukmanov, Alexander Bogdanov Berezovsky, Yaron Shoham, Yuval Krieger
Background: Muscle activity contributes to the enhancement of facial aging deformity, blepharospasm, cerebral palsy spasticity, trismus, torticollis, and other conditions. Myotomy of the involved muscles in order to reduce the deformity has variable success rates due to muscle healing and regeneration of activity. Objectives: The goal of this study was to investigate whether blocking striated muscle activity with Botulinum toxin (BtxA) during the healing time after myotomy alters the healing process and reduces long-term muscle activity...
November 14, 2017: Aesthetic Surgery Journal
https://www.readbyqxmd.com/read/29133972/the-relationship-between-the-physical-cost-index-and-knee-extensor-strength-in-children-with-hemiplegic-cerebral-palsy
#6
Kenji Takaki, Yasuaki Kusumoto
[Purpose] Lower extremity strength is a contributing factor to energy efficiency of gait. However, this contribution has not previously been evaluated in children with hemiplegic cerebral palsy (CP). The aim of this study was to evaluate the association between energy consumption, measured by the physical cost index (PCI), and strength of lower extremity, measured by the maximum knee extensor strength (MKES), in children with hemiplegic CP. [Subjects and Methods] Subjects were 10 children (4 males and 6 females; age, 7-17 years) with hemiplegic CP, but no history of orthopedic intervention or botulinum toxin treatment over the 1 year prior to the assessment...
October 2017: Journal of Physical Therapy Science
https://www.readbyqxmd.com/read/28949368/value-of-botulinum-toxin-injections-preceding-a-comprehensive-rehabilitation-period-for-children-with-spastic-cerebral-palsy-a-cost-effectiveness-study
#7
Fabienne Schasfoort, Annet Dallmeijer, Robert Pangalila, Coriene Catsman, Henk Stam, Jules Becher, Ewout Steyerberg, Suzanne Polinder, Johannes Bussmann
OBJECTIVE: Despite the widespread use of botulinum toxin in ambulatory children with spastic cerebral palsy, its value prior to intensive physiotherapy with adjunctive casting/orthoses remains unclear. DESIGN: A pragmatically designed, multi-centre trial, comparing the effectiveness of botulinum toxin + intensive physiotherapy with intensive physiotherapy alone, including economic evaluation. SUBJECTS/PATIENTS: Children with spastic cerebral palsy, age range 4-12 years, cerebral palsy-severity Gross Motor Function Classification System levels I-III, received either botulinum toxin type A + intensive physiotherapy or intensive physiotherapy alone and, if necessary, ankle-foot orthoses and/or casting...
September 26, 2017: Journal of Rehabilitation Medicine
https://www.readbyqxmd.com/read/28834868/outcomes-of-intrathecal-baclofen-therapy-in-patients-with-cerebral-palsy-and-acquired-brain-injury
#8
Young Kwon Yoon, Kil Chan Lee, Han Eol Cho, Minji Chae, Jin Woo Chang, Won Seok Chang, Sung-Rae Cho
Intrathecal baclofen (ITB) has been known to reduce spasticity which did not respond to oral medications and botulinum toxin treatment. However, few results have been reported comparing the effects of ITB therapy in patients with cerebral palsy (CP) and acquired brain injury. This study aimed to investigate beneficial and adverse effects of ITB bolus injection and pump therapy in patients with CP and to compare outcomes to patients with acquired brain injury such as traumatic brain injury and hypoxic brain injury...
August 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28825663/efficacy-of-repeated-botulinum-toxin-type-a-injections-for-spastic-equinus-in-children-with-cerebral-palsy-a-secondary-analysis-of-the-randomized-clinical-trial
#9
Bo Young Hong, Hyun Jung Chang, Sang-Jee Lee, Soyoung Lee, Joo Hyun Park, Jeong-Yi Kwon
Botulinum toxin A is considered an important tool to control spasticity in children with cerebral palsy. Several factors are known to affect the efficacy of botulinum toxin, such as dosage, appropriate muscle selection and application, age, and accompanying therapy. A multicenter, double-blind, randomized, prospective phase III clinical trial of botulinum toxin A for the treatment of dynamic equinus in 144 children with cerebral palsy was performed to compare the efficacies of letibotulinumtoxin A and onabotulinumtoxin A...
August 21, 2017: Toxins
https://www.readbyqxmd.com/read/28820439/efficacy-and-safety-of-letibotulinum-toxin-a-for-the-treatment-of-dynamic-equinus-foot-deformity-in-children-with-cerebral-palsy-a-randomized-controlled-trial
#10
Hyun Jung Chang, Bo Young Hong, Sang-Jee Lee, Soyoung Lee, Joo Hyun Park, Jeong-Yi Kwon
The objective of this clinical trial was to compare the efficacy and safety of letibotulinum toxin A and onabotulinum toxin A for improving dynamic equinus foot deformity in children with cerebral palsy (CP). In total, 144 children with spastic CP who had dynamic equinus foot deformity were assigned randomly to the Botulax group (injection of letibotulinum toxin A) or the Botox group (injection of onabotulinum toxin A). The Physician's Rating Scale (PRS), ankle plantar flexor spasticity using the Modified Tardieu Scale, the Gross Motor Function Measure (GMFM)-88, and the GMFM-66 were completed before injection and at 6, 12, and 24 weeks after injection...
August 18, 2017: Toxins
https://www.readbyqxmd.com/read/28818530/recent-developments-in-clinical-trials-of-botulinum-neurotoxins
#11
Antoniangela Cocco, Alberto Albanese
Botulinum neurotoxins (BoNTs) are increasingly used in clinical practice for several indications. Following the pioneering years of discoveries, the recent years have witnessed an increase of new indications and new toxin brands. We review here the clinical trials on BoNTs performed since 2014 and put them into perspective. We also review the ongoing trials listed by the National Institutes of Health registry (Clinicaltrials.gov). The following indications are reviewed here: blepharospasm, cervical dystonia, spasticity, cerebral palsy, urinary incontinence, headache, topical formulations, postoperative cardiac arrhythmia, keloids and scars...
August 14, 2017: Toxicon: Official Journal of the International Society on Toxinology
https://www.readbyqxmd.com/read/28741118/strategies-to-decrease-injection-site-pain-in-botulinum-toxin-therapy
#12
Lejla Paracka, Katja Kollewe, Florian Wegner, Dirk Dressler
Botulinum toxin is now used for numerous indications including dystonias, spasticity, cerebral palsy, hyperhidrosis, cosmetics and chronic migraine. It has to be injected into its target tissues thus causing injection site pain. We wanted to compare the efficacy of various analgesic interventions suggested for reduction of injection site pain. In 13 healthy controls, pain thresholds in the fingertips II and III bilaterally were determined by the Mechanical Pain Threshold Test and the Repetitive Pain Stimulation Test at baseline and under nitrous oxide/oxygen, ice spray, local anaesthetic cream and forearm ischaemia...
October 2017: Journal of Neural Transmission
https://www.readbyqxmd.com/read/28735160/longitudinal-assessment-of-gait-quality-in-children-with-bilateral-cerebral-palsy-following-repeated-lower-limb-intramuscular-botulinum-toxin-a-injections
#13
Felicity A Read, Roslyn N Boyd, Lee A Barber
BACKGROUND: Serial lower limb intramuscular Botulinum toxin-A (BoNT-A) injections are administered to children with bilateral spastic cerebral palsy (BCP) to reduce spasticity, improve walking and functional mobility, and delay the need for orthopaedic surgery. Gait quality is clinically assessed following BoNT-A with 2D video gait assessments (2DVGA) using the Edinburgh Visual Gait Score (EVGS). AIM: To determine the effect of three consecutive treatment cycles of lower limb intramuscular BoNT-A injections on gait quality using the EVGS in children with BCP by retrospectively reviewing repeated 2DVGA measures...
July 20, 2017: Research in Developmental Disabilities
https://www.readbyqxmd.com/read/28724781/muscle-disuse-caused-by-botulinum-toxin-injection-leads-to-increased-central-gain-of-the-stretch-reflex-in-the-rat
#14
Jessica Pingel, Hans Hultborn, Lui Näslund-Koch, Dennis B Jensen, Jacob Wienecke, Jens Bo Nielsen
Botulinum toxin (Btx) is used in children with cerebral palsy and in other neurological patients to diminish spasticity and reduce the risk of development of contractures. We investigated changes in the central gain of the stretch reflex circuitry in response to Btx injection in the triceps surae muscle in rats. Experiments were performed in 21 rats. Eight rats were a control group, and 13 rats were injected with 6 IU of Btx in the left triceps surae muscle. Two weeks after Btx injection, larger monosynaptic reflexes (MSR) were recorded from the left (injected) than the right (noninjected) L4 + L5 ventral roots following stimulation of the corresponding dorsal roots...
October 1, 2017: Journal of Neurophysiology
https://www.readbyqxmd.com/read/28650877/the-resurgence-of-botulinum-toxin-injection-for-strabismus-in-children
#15
REVIEW
Marielle Mahan, J Mark Engel
PURPOSE OF REVIEW: The present review discusses recent advances in the use of botulinum toxin for the management of strabismus in children. RECENT FINDINGS: Botulinum toxin injection produces similar results compared to surgery for certain subtypes of strabismus, especially acute onset esotropia. It may be more effective in many subtypes of esotropia where surgery has been less reliable, including partially accommodative esotropia, esotropia associated with cerebral palsy, and thyroid eye disease...
September 2017: Current Opinion in Ophthalmology
https://www.readbyqxmd.com/read/28634003/spasticity-video-challenge-a-look-at-methods-for-addressing-difficult-cases
#16
Katharine E Alter, Mark Gormley, Atul T Patel
As seen in this CME online activity (available at http://courses.elseviercme.com/spasticity/662e), treatment of patients with spasticity due to upper motor neuron syndromes, including traumatic brain injury, stroke, and cerebral palsy, is multifaceted, involving chemodenervation, systemic medications, surgical therapy, rehabilitation efforts, and home care. Optimal care begins with the recognition that each patient's impairments are unique and must be assessed carefully to determine the impact of muscle overactivity, loss of dexterity, and weakness on passive and active function in the context of the patients' goals...
June 19, 2017: PM & R: the Journal of Injury, Function, and Rehabilitation
https://www.readbyqxmd.com/read/28623614/abobotulinumtoxina-a-review-in-pediatric-lower-limb-spasticity
#17
REVIEW
Yahiya Y Syed
AbobotulinumtoxinA (Dysport(®)) is currently the only botulinum toxin A formulation approved by the US FDA for the treatment of lower limb spasticity in pediatric patients aged ≥2 years. Intramuscular abobotulinumtoxinA was approved based on the results of a pivotal phase 3 trial in children with lower limb spasticity due to cerebral palsy. In this trial, a single treatment cycle with abobotulinumtoxinA 10-15 U/kg/leg injected into the gastrocnemius and soleus muscles significantly improved ankle plantar flexor muscle tone (primary endpoint), with abobotulinumtoxinA recipients showing a significant response to treatment relative to placebo...
August 2017: Paediatric Drugs
https://www.readbyqxmd.com/read/28604409/posture-dependent-dysphagia-after-botulinum-toxin-type-a-injection-at-sternocleidomastoid-in-a-patient-with-athetoid-cerebral-palsy
#18
Won Kee Chang, Keewon Kim, Han Gil Seo, Ja-Ho Leigh, Moon Suk Bang
Cervical dystonia is a common issue in patients with athetoid cerebral palsy. Botulinum toxin injection to dystonic cervical muscles is a well-recognized treatment option, but it is known to be associated with dysphagia. Previously reported cases of dysphagia after botulinum toxin injection to the sternocleidomastoid muscle were related to the regional spread of toxin to the pharyngeal muscles. We report a unique case of posture-dependent dysphagia due to preactivation of the suprahyoid and infrahyoid muscles to compensate for impaired head stabilization by the weakened sternocleidomastoid muscle while swallowing...
June 9, 2017: American Journal of Physical Medicine & Rehabilitation
https://www.readbyqxmd.com/read/28582880/the-effect-of-botulinum-toxin-a-botox-injections-used-to-treat-limb-spasticity-on-speech-patterns-in-children-with-dysarthria-and-cerebral-palsy-a-report-of-two-cases
#19
Marilyn Seif Workinger, Raymond D Kent, Jill R Meilahn
Botulinum toxin A (Btx-A) injections are used to treat limb spasticity in children with cerebral palsy (CP) resulting in improved gross and fine motor control. This treatment has also been reported to have additional functional effects, but the effect of treatment on speech has not been reported. This report presents results of longitudinal speech evaluation of two children with CP given injections of Btx-A for treatment of limb spasticity. Speech evaluations were accomplished at baseline (date of injections) and 4- and 10-weeks post-injections...
May 19, 2017: Journal of Pediatric Rehabilitation Medicine
https://www.readbyqxmd.com/read/28520679/knee-recurvatum-in-children-with-spastic-diplegic-cerebral-palsy
#20
Jeremy Bauer, K Patrick Do, Jing Feng, Rosemary Pierce, Michael Aiona
BACKGROUND: The purpose of this study is to determine which factors drive patients with diplegic cerebral palsy to walk without knee recurvatum despite hyperextension of the knee on physical examination. METHODS: A retrospective review was conducted of all data collected in the Gait Analysis Laboratory between 1999 and 2014. Patients with spastic diplegic cerebral palsy and at least 5 degrees of knee extension on clinical examination were identified for the study...
May 17, 2017: Journal of Pediatric Orthopedics
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