Improvement on GMFCS Level of Patients With Cerebral Palsy Treated by Repeated Botulinum Toxin-A
Condition: Cerebral Palsy
MeSH terms: Cerebral Palsy
Study type: Observational

Summary: 
      The aim of this retrospective, monocenter, observational study is to evaluate the changes in
      GMFCS levels of children with cerebral palsy (CP) who received repeated Botulinum Toxin-A
      (BoNT-A) injections in the lower limb(s) with an integrated treatment approach in Kocaeli
      University Department of PMR and Izmit Rehabilitation Center.
    

Detailed description: 
      It is generally agreed that children with CP reach their gross motor potential by the age of
      3.5-5 and a child or young person over the age of 5 years will not improve their GMFCS level.
      BoNT-A is an important treatment in children with CP because it is safe in young children and
      allows combined treatment. The reduction in muscle tone by this selective treatment provides
      an opportunity to allow and optimize the effects of other treatments including orthoses,
      casting, conventional therapies and activity based functional trainings. For this reason,
      BoNT-A injections are always combined with other therapies in Kocaeli University Department
      of PMR and Izmit Rehabilitation Center. Adjunctive treatments in this department consists of
      serial casting, orthotics, physical therapy, occupational therapy, cognitive rehabilitation,
      special educational programs, non invasive brain stimulation with transcranial direct
      current, neurofeedback, biofeedback, electrical stimulation and other physical therapy
      modalities, activity based models including functional ambulatory training, constraint
      induced therapy, bilateral therapy, hippotherapy, music therapy by singing or playing
      percussive instruments or moving and dancing to music, and robotic rehabilitation.
      Individualized intensive combined treatment plan was applied by an appropriate neurorehab
      team to each patient within the department as a half day or full day program usually for 3
      weeks starting 1 week or 10 days after BONT-A injections. In thıs retrospective, monocenter,
      observational study a software database program will be developed and all the present data
      about the demographic and clinic properties of the patients, all information about BoNT-A
      injections including safety and applied adjunctive treatments will be entered and reviewed.
    

Intervention name(s): Botulinum toxin type A; Physical therapy
Intervention type(s): Drug; Other
Intervention description(s): Repeated injections to hypertonic muscles; 3 weeks intensive program 1 week -10 days after BoNT-A injections
Other intervention name(s): Botox, Dysport
Intervention MeSH terms: Botulinum Toxins; Botulinum Toxins, Type A; abobotulinumtoxinA
Observational model: Case-Only
Time perspective: Retrospective
Sampling method: Non-Probability Sample
Study population: 
        All children diagnosis of cerebral palsy with respect to Rosenbaum criteria having received
        at least 2 repeated BoNT-A injections to lower limb(s) as well as an integrated treatment
        approach (an intensive therapy protocol consisted of a half day or entire day program in
        Kocaeli University Department of PMR and Izmit Rehabilitation Center) within the last 10
        years