Article

This study aimed to assess short-term effects of botulinum toxin A in
ambulant adults with spastic cerebral palsy.A single-centre
double-blind, placebo-controlled, randomized clinical trial. SUBJECTS: Patients
were recruited through advertisements. Inclusion criteria were: spastic cerebral
palsy, age 18-65 years, decreased walking, walking without aids for minimum 20 m,
and no cognitive impairments. METHODS: A total of 66 participants, mean age 37
(standard deviation 11.4) years, were enrolled and received injections of either
botulinum toxin A (n=33) or placebo (n=33). Primary outcomes were: sagittal
kinematics of ankle, knee and hip, and health-related quality of life (Short Form
36). Secondary outcomes were: visual analogue scale for
muscle-stiffness/spasticity, Timed Up and Go, 6-minute walk test, and Global
Scale of perceived effect. RESULTS: No significant differences were found between
the groups in the primary outcomes. In the secondary outcomes the botulinum toxin
A group rated improvement in visual analogue scale muscle-stiffness/spasticity
and the Global Scale of perceived effect. No serious adverse events occurred.
CONCLUSION: Botulinum toxin A injections alone gave no benefit over placebo in
lower limb sagittal kinematics and Short Form 36 in ambulatory adults with
cerebral palsy. However, self-reported rating of muscle-stiffness/spasticity and
global effects indicated positive effects of botulinum toxin A. Further studies
with specific post-injection rehabilitation and longer study period are warranted.

Langue : ANGLAIS