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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: April 2004 - Volume 83 - Issue 4 - p 284-291
doi: 10.1097/01.PHM.0000118038.02326.CA
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.

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.

Copyright © 2004 Wolters Kluwer Health, Inc. All rights reserved.