The Relationship between Botulinum Toxin Intervention and Target Muscles in Children With Spastic Cerebral Palsy: A Retrospective Cohort Study
DOI:
https://doi.org/10.25759/spmfr.538Keywords:
Cerebral Palsy, Spasticity, Botulinum Toxin, Target musclesAbstract
Introduction: Cerebral palsy (CP) is a non-progressive neurological condition often associated with spasticity, which can impair motor development. Botulinum toxin type A (BoNT-A) is an effective therapeutic option in managing spasticity in children with CP. The present study aimed to characterize the pediatric population with spastic CP who underwent BoNT-A treatment at a hospital in Portugal, identifying the target muscles and the most prevalent secondary alterations associated with spastic cerebral palsy in the context of the intervention.
Methods: A retrospective cohort study was conducted including children with spastic CP followed at the Pediatric Rehabilitation outpatient consultation of a Physical and Rehabilitation Medicine Department at a hospital in Portugal, between 2015 and 2024. The study included children with spastic CP, unilateral or bilateral (affecting 2–4 limbs), aged 5 to 18 years, who underwent BoNT-A intervention in the upper and/or lower limbs.
Results: Of the 87 identified cases of CP, 22 children met the inclusion criteria. The muscle groups most frequently treated with BoNT-A were in the lower limbs (gastrocnemius, soleus, tibialis posterior and semitendinosus/semimembranosus) (n=16, 72.7%), primarily aimed at improving gait. In children with GMFCS levels IV and V, the intervention focused on pain control, prevention of luxations/musculoskeletal deformities, and facilitation of hygiene care.
Conclusion: Chemodenervation with BoNT-A type A in children with spastic CP demonstrates a functional-level dependent pattern: treatment of lower limb muscles in ambulatory children, and focus on pain control and prevention of complications in children with more limited mobility, reflecting the adaptation of treatment strategies.
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