肉毒桿菌毒素治療腦性麻痺兒童痙攣之臨床成效

Clinical Effects of Botulinum Toxin on Spasticity Management in Children with Cerebral Palsy

吳恩瑄(En-Shiuan Wu) ； 陳嘉玲(Chia-Ling Chen) ； 黃美涓(Alice M.K. Wong) ； 黃慶凱(Ching-Kai Wong) ； 陳俊賢(Jun-Xiao Chen) ； 羅適明(Shin-Ming Lo)

《台灣復健醫學雜誌》 32卷4期 (2004/12) Pp. 171-180

https://doi.org/10.6315/2004.32(4)01

摘要

Botulinum toxin type A (BTA) has treated spasticity in cerebral palsy (CP) in recent years. This study investigated both the clinical effects and gait improvements of BTA on spasticity management in children with CP.
Twenty-nine children with spastic CP (2-10 years old) were recruited into this study. All subjects received complete clinical assessments, video recording and functional assessments before and 1-3 months after BTA treatment. A questionnaire was employed for the evaluation of parents’ subjective satisfaction. Clinical assessments included muscle tone and joint range of motion (ROM) of bilateral lower limbs. ROMs, including dynamic (R1) and static (R2), were measured by Modified Tardieu Scale. Functional assessments comprised Gross Motor Function Measure (GMFM) and Minear’s classification. Gait on videotape was analyzed by observational gait scale (OGS)
Three months after BTA injection, the muscle tone decreased significantly in all muscles. R1 improved in all muscle groups (P＜0.01); however, R2 slightly improved in hip adductors and hamstrings (P＜0.05). Meanwhile, GMFM and Minear’s scores also had significant improvement (P＜0.05). The OGS scores improved significantly in most gait parameters (P＜0.05) except knee position and hindfoot at midstance. Moreover, most parents considered children’s ability of daily living improved. All parents believed children’s walking ability improved as well.
The results reveaed that BTA treatment could improve ROM, gross motor, functional ability and gait by reducing the muscle tone.

關鍵字

腦性麻痺 ； 肉毒桿菌毒素 ； 痙攣 ； 步態 ； 運動功能

並列摘要

Botulinum toxin type A (BTA) has treated spasticity in cerebral palsy (CP) in recent years. This study investigated both the clinical effects and gait improvements of BTA on spasticity management in children with CP.
Twenty-nine children with spastic CP (2-10 years old) were recruited into this study. All subjects received complete clinical assessments, video recording and functional assessments before and 1-3 months after BTA treatment. A questionnaire was employed for the evaluation of parents’ subjective satisfaction. Clinical assessments included muscle tone and joint range of motion (ROM) of bilateral lower limbs. ROMs, including dynamic (R1) and static (R2), were measured by Modified Tardieu Scale. Functional assessments comprised Gross Motor Function Measure (GMFM) and Minear’s classification. Gait on videotape was analyzed by observational gait scale (OGS)
Three months after BTA injection, the muscle tone decreased significantly in all muscles. R1 improved in all muscle groups (P＜0.01); however, R2 slightly improved in hip adductors and hamstrings (P＜0.05). Meanwhile, GMFM and Minear’s scores also had significant improvement (P＜0.05). The OGS scores improved significantly in most gait parameters (P＜0.05) except knee position and hindfoot at midstance. Moreover, most parents considered children’s ability of daily living improved. All parents believed children’s walking ability improved as well.
The results reveaed that BTA treatment could improve ROM, gross motor, functional ability and gait by reducing the muscle tone.

並列關鍵字

cerebral palsy ； botulinum toxin ； spasticity ； gait ； motor function