Article

The aim of this pilot study was to examine changes in different
aspects of impairment, including spasticity in the upper limbs, of hemiplegic
children following botulinum toxin type A intervention. Progress was assessed
using standard clinical measurements and a robotic device. DESIGN: Pre-post
multiple baseline. SUBJECTS:
Six children with hemiplegia. METHODS: Botulinium
toxin type A injections were administered into the affected upper limb muscles.
Outcomes were evaluated before and one month after the injection. Outcome
assessments included: Melbourne Scale, Modified Ashworth Scale (MAS) and Passive
Range of Motion. Furthermore, a robotic device was employed as an evaluation
tool. RESULTS: Patients treated with botulinum toxin type A had significantly
greater reduction in spasticity (MAS, p < 0.01), which explains an improvement in
upper limb function and quality movement measured with the Melbourne Scale (p <
0.01). These improvements are consistent with robot-based evaluation results that
showed statistically significant changes (p < 0.01) following botulinum toxin
type A injections. CONCLUSION: The upper limb performs a wide variety of
movements. The multi-joint nature of the task during the robot-mediated
evaluation required active control of joint interaction forces. There was good
correlation between clinical scales and robotic evaluation. Hence the
robot-mediated assessment may be used as an additional tool to quantify the
degree of motor improvement after botulinum toxin type A injections.

Langue : ANGLAIS