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Clinical Effects of Botulinum Toxin A and Phenol Block on Gait in Children with Cerebral Palsy

Wong, Alice M. K. MD; Chen, Chia-Ling MD, PhD; Chen, Carl P. C. MD; Chou, Shih-Wei MD, PhD; Chung, Chia-Ying MD; Chen, Max J. L. MD

American Journal of Physical Medicine & Rehabilitation:
Research Article

Wong AMK, Chen CL, Chen CPC, Chou SW, Chung CY, Chen MJL: Clinical effects of botulinum toxin a and phenol block on gait in children with cerebral palsy. Am J Phys Med Rehabil 2004;83:284–291.

Objective: To compare the treatment effectiveness of botulinum toxin type A (BTX-A) and phenol blocks in managing lower limb spasticity and gait dysfunction in children with cerebral palsy.

Design: This is a case-controlled study that took place in a tertiary center’s gait laboratory. A total of 27 ambulatory children with cerebral palsy spastic diplegia, aged from 3 to 7 yrs, and 20 normal children were recruited into this study. Sixteen children with cerebral palsy received BTX-A injections, and 11 received phenol motor point blocks. Gait analyses were assessed by a portable computer-assisted system (Computer DynoGraphy, Infotronic, The Netherlands). Both the BTX-A and phenol groups received gait analysis at 1 wk before and 2 mos after injection treatments.

Results: Significant improvements in gait variables of velocity and cadence were noted in children with cerebral palsy after BTX-A injections as compared with the phenol block group. Gaitline and cyclogram patterns also improved significantly in the BTX-A group. The adverse clinical effects of BTX-A injections were less severe as compared with phenol injections.

Conclusions: BTX-A injections demonstrated superior treatment effects in improving gait variables and patterns in children with spastic diplegia as compared with phenol blocks. BTX-A injections also revealed fewer clinical side effects and were well tolerated by children with cerebral palsies.

Author Information

From the Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Kwei-Shan, Tao-Yuan, Taiwan.

All correspondence and requests for reprints should be addressed to Alice M. K. Wong, MD, Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, 5, Fu-Hsin Street, Kwei-Shan, Tao-Yuan, 333, Taiwan.

© 2004 Lippincott Williams & Wilkins, Inc.