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Toxins 2017, 9(8), 253; https://doi.org/10.3390/toxins9080253

Efficacy of Repeated Botulinum Toxin Type A Injections for Spastic Equinus in Children with Cerebral Palsy—A Secondary Analysis of the Randomized Clinical Trial

1
Department of Rehabilitation Medicine, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Suwon 16247, South Korea
2
Department of Physical Medicine & Rehabilitation, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon 51353, South Korea
3
Department of Rehabilitation Medicine, Daejeon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Daejeon 34943, South Korea
4
Department of Physical Medicine & Rehabilitation, Keimyung University, Dongsan Medical Center, Daegu 41931, South Korea
5
Department of Rehabilitation Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, South Korea
6
Department of Physical and Rehabilitation Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, South Korea
These authors contributed to this work equally.
*
Author to whom correspondence should be addressed.
Academic Editor: Joseph Jankovic
Received: 12 July 2017 / Revised: 8 August 2017 / Accepted: 18 August 2017 / Published: 21 August 2017
(This article belongs to the Section Bacterial Toxins)
Full-Text   |   PDF [266 KB, uploaded 30 August 2017]

Abstract

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. Secondary analyses were performed to evaluate factors that affected the outcome, focusing on the number of times injections were repeated. Effectiveness was defined as a change of 2 or more in the physician’s rating scale. Multivariate regression analyses were performed with multiple variables. The first injection of botulinum toxin A significantly improved D subscale of Gross Motor Function Measure-88 scores at 3 months compared to repeated injections (p < 0.05). After 6 months, patients who had one injection or none before the study showed significantly better outcomes than those who had more than one injection in terms of observational gait scores. View Full-Text
Keywords: cerebral palsy; spasticity; botulinum toxin; onabotulinumtoxin A; letibotulinumtoxin A; equinus cerebral palsy; spasticity; botulinum toxin; onabotulinumtoxin A; letibotulinumtoxin A; equinus
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited (CC BY 4.0).

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Hong, B.Y.; Chang, H.J.; Lee, S.-J.; Lee, S.; Park, J.H.; Kwon, J.-Y. Efficacy of Repeated Botulinum Toxin Type A Injections for Spastic Equinus in Children with Cerebral Palsy—A Secondary Analysis of the Randomized Clinical Trial. Toxins 2017, 9, 253.

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