BACKGROUND: This study reports on the effects of botulinum toxin A (BoNT-A) injections in the upper extremity (UE) in @entity1 with unilateral @entity306 (uCP) combined with bimanual task-oriented therapy (BITT) or either treatment modality performed separately. Bimanual activities were measured with the @entity8566 ( @entity8566 ), the ABILHand-Kids questionnaire (AK), the Observational Skills Assessment Score (OSAS). Goal achievement was measured with Goal Attainment Scaling (GAS), using blind video assessment, and the Canadian Occupational Performance Measure (COPM). METHODS: Thirty-five @entity1 , mean age 7.14 years ( @entity168 2.63), 11 Manual Ability Classification Score (MACS) I, 15 MACS II and 9 MACS III, participated. The trial started with four study groups: BoNT-A-only (n = 5), BITT-only (n = 11), BoNT-A +   BITT (n = 13), and control (n = 6). Twenty-two @entity1 were randomised, 13 @entity1 received their parents' preferred treatment: BoNT-A +   BITT or BITT-only. Three comparisons were analysed: BITT (BoNT-A +   BITT and BITT-only; n = 24) versus no BITT (BoNT-A-only and control; n = 11), BoNT-A (BoNT-A-only and BoNT-A +   BITT; n = 18) versus no BoNT-A (BITT-only and control; n = 17), and the additional effect of BoNT-A (BoNT-A +   BITT versus BITT-only). Follow-up time: 24 weeks. RESULTS: No significant differences between the groups were found on the @entity8566 . The amount of use of both hands on the OSAS was significantly better in the BoNT-A group in the beading and sandwich-making task. The BoNT-A group also showed significant improvement in the quality scores of the OSAS: the wrist position during grasping and holding, especially in the younger @entity1 . The BITT group improved significantly on the AK and significantly more on the performance and satisfaction scores of the COPM at 12 and 24 weeks regarding several goals. BoNT-A showed a significant negative effect at 12 and 24 weeks in the most important goal. BITT, more than BoNT-A   +   BITT, showed positive effects on the GAS score at 12 (significant), 18 and 24 weeks. CONCLUSIONS: BoNT-A has a positive effect on quality of movement and amount of use of the affected UE during the 3 months' working time. BoNT-A has no additional effect on bimanual performance and goal achievement. BITT has a positive effect on goal achievement and bimanual performance, even up to 6 weeks after therapy had stopped. TRIAL REGISTRATION: Current Controlled Trials ISRCTN69541857.

Effects of botulinum toxin A and/or bimanual task-oriented therapy on upper extremity activities in unilateral XXXX : a clinical trial.

@entity1 :: ('9606', 'Species') :: ['children'] @entity168 :: ('MESH:D029461', 'Disease') :: ['SD'] @entity8566 :: ('MESH:D060831', 'Disease') :: ['AHA', 'Assisting Hand Assessment'] @entity306 :: ('MESH:D002547', 'Disease') :: ['Cerebral Palsy']
@entity306 :: (MESH:D002547,Disease) :: ['Cerebral Palsy']
