Article

OBJECTIVE: To measure the effect of intensive therapy and the lasting effect of a
standardized functional training programme with vs. without the addition of
chemodernervation of the muscles of the forearm and hand. PATIENTS AND METHODS:
Twenty children with spastic hemiplegia, aged 4-16 years, were matched for
baseline characteristics and randomized to standardized task-oriented therapy for
6 months with or without botulinum toxin injections. Dynamic kinematic outcome
measures were: speed, accuracy, end-point spread and performance. Measurements of
active and passive range of motion, stretch-restricted angle of the elbow and
wrist, Ashworth scores and Melbourne Assessment of Unilateral Upper Limb Function
were made. All measures were performed at baseline, 2 weeks after injection of
botulinum toxin and after 6 months (at the end of therapy), and 3 months after
end of the therapy. RESULTS: Clinical measures showed improvement in both groups.
However, no significant differences emerged between groups on functional
measures. Directly after the botulinum toxin injection all kinematic outcome
measures showed a decrease, but baseline values were re-established during the
therapy period. After botulinum toxin injections a temporarily significant
greater increase in speed and performance was found. These results illustrate the
need for further quantitative research into the effects of botulinum toxin.

Langue : ANGLAIS