Article

OBJECTIVE: To compare the clinical outcomes of two different injection
techniques, one guided by electric stimulation and the other by sonography, for
botulinum toxin A injection into calf muscles for the treatment of spastic
equinus in children with cerebral palsy. DESIGN:
Thirty-two children with
cerebral palsy with spastic equinus gait were enrolled in separate categories
according to their level under the Gross Motor Function Classification System and
divided into two groups with alternate allocation: sonography-guided group and
electric stimulation-guided group. Equal amounts of botulinum toxin A were
injected into the gastrocnemius at four to six points in 30 children with
cerebral palsy. The injection was guided by electric stimulation in 14 and by
ultrasonography in 16 children. Modified Ashworth Scale, Modified Tardieu Scale,
Selective Motor Control, and Physician's Rating Scale were measured at baseline,
1 mo, and 3 mos posttreatment. RESULTS: Subscales of the Physician's Rating Scale
(gait pattern and hindfoot position-maximum foot/floor contact during stance)
significantly improved in the sonography-guided group.
No statistical differences
were noted in Modified Ashworth Scale, Modified Tardieu Scale, and Selective
Motor Control. CONCLUSIONS: Visual feedback by ultrasonography could improve the
accuracy of selective neuromuscular blocking of the gastrocnemius.

Langue : ANGLAIS