Article

AIM: To validate a detailed intramuscular needle placement protocol using passive
muscle stretching and relaxing for botulinum neurotoxin type A (BoNT-A) treatment
in the lower extremity of children with spastic cerebral palsy (CP), with
verification by electrical stimulation. METHOD: A prospective observational study
was performed in 75 children with spastic CP who received regular BoNT-A
treatment under general anaesthesia (52 males, 23 females; mean age 8y 9mo, SD 3y 7mo, range 4-18y; mean body mass index 16.2, SD 3.7, range 7.7-26.7). A total of
1084 intramuscular needle placements using passive muscle stretching and relaxing
were verified by electrical stimulation. Primary outcome was the positive
predictive value. RESULTS: Intramuscular needle placement in the muscles adductor
brevis, adductor longus, gracilis, semimembranosus, semitendinosus, biceps
femoris, rectus femoris, and lateral and medial heads of the gastrocnemius and
soleus had a positive predictive value ranging from 85.7% to 100% (95% confidence
interval ranging from 71.5-89.9% to 91.4-100%). INTERPRETATION: This validated
detailed protocol for intramuscular needle placement using passive muscle
stretching and relaxing for BoNT-A treatment in the lower extremity of children
with spastic CP is reliable and has a high positive predictive value.
CI - (c) 2016 Mac Keith Press.

Langue : ANGLAIS