Changes in Motor Function in a Child with Cerebral Palsy Following Multiple Botulinum Toxin Injections: A Case Report
<b>Objective:</b> The objective of this study was to examine 7 years of clinical physical therapy measures in a child with spastic diplegic cerebral palsy (CP) who received multiple botulinum toxin type A (BoNT-A) injections. <b>Methods:</b> A boy diagnosed with spastic diple...
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MDPI AG
2025-06-01
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| Series: | Children |
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| Online Access: | https://www.mdpi.com/2227-9067/12/6/761 |
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| author | Nancy Lennon Chris Church Jose J. Salazar-Torres Faithe Kalisperis Freeman Miller Jason J. Howard |
| author_facet | Nancy Lennon Chris Church Jose J. Salazar-Torres Faithe Kalisperis Freeman Miller Jason J. Howard |
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| description | <b>Objective:</b> The objective of this study was to examine 7 years of clinical physical therapy measures in a child with spastic diplegic cerebral palsy (CP) who received multiple botulinum toxin type A (BoNT-A) injections. <b>Methods:</b> A boy diagnosed with spastic diplegic CP, Gross Motor Function Classification System level II, received four episodes of BoNT-A from ages 4 to 10 years. Serial clinical measures of muscle strength, spasticity, lower extremity passive range of motion, gait kinematics, and gross motor function were collected in the gait analysis lab from age 3 to 10 years. <b>Results:</b> After improvements from ages 3 to 7 years, gait and motor function declined from ages 8 to 10 years with no improvement in spasticity or range of motion measurements. Muscle testing and gait kinematics defined a loss of plantarflexion strength. <b>Conclusions:</b> A decline in gross motor skills and gait is not typical for a child with spastic diplegia at age 8 years and its association with BoNT-A injections needs to be considered. This case demonstrates the importance of evaluating treatment outcomes for youth with spastic CP utilizing a set of reliable, and clinically useful measures of strength, spasticity, contracture, gait, and motor function. Critical examination of impairment and functional level measures defines goals, guides treatment, and evaluates outcomes. With this approach, pediatric therapists can empower families to make well-informed decisions. |
| format | Article |
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| institution | Matheson Library |
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| language | English |
| publishDate | 2025-06-01 |
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| spelling | doaj-art-5d50861379d94e3b8e3fa35fe79e78de2025-06-25T13:38:15ZengMDPI AGChildren2227-90672025-06-0112676110.3390/children12060761Changes in Motor Function in a Child with Cerebral Palsy Following Multiple Botulinum Toxin Injections: A Case ReportNancy Lennon0Chris Church1Jose J. Salazar-Torres2Faithe Kalisperis3Freeman Miller4Jason J. Howard5Department of Orthopaedics, Nemours Children’s Health, 1600 Rockland Rd., Wilmington, DE 19803, USADepartment of Orthopaedics, Nemours Children’s Health, 1600 Rockland Rd., Wilmington, DE 19803, USADepartment of Orthopaedics, Nemours Children’s Health, 1600 Rockland Rd., Wilmington, DE 19803, USADepartment of Orthopaedics, Nemours Children’s Health, 1600 Rockland Rd., Wilmington, DE 19803, USADepartment of Orthopaedics, Nemours Children’s Health, 1600 Rockland Rd., Wilmington, DE 19803, USADepartment of Orthopaedics, Nemours Children’s Health, 1600 Rockland Rd., Wilmington, DE 19803, USA<b>Objective:</b> The objective of this study was to examine 7 years of clinical physical therapy measures in a child with spastic diplegic cerebral palsy (CP) who received multiple botulinum toxin type A (BoNT-A) injections. <b>Methods:</b> A boy diagnosed with spastic diplegic CP, Gross Motor Function Classification System level II, received four episodes of BoNT-A from ages 4 to 10 years. Serial clinical measures of muscle strength, spasticity, lower extremity passive range of motion, gait kinematics, and gross motor function were collected in the gait analysis lab from age 3 to 10 years. <b>Results:</b> After improvements from ages 3 to 7 years, gait and motor function declined from ages 8 to 10 years with no improvement in spasticity or range of motion measurements. Muscle testing and gait kinematics defined a loss of plantarflexion strength. <b>Conclusions:</b> A decline in gross motor skills and gait is not typical for a child with spastic diplegia at age 8 years and its association with BoNT-A injections needs to be considered. This case demonstrates the importance of evaluating treatment outcomes for youth with spastic CP utilizing a set of reliable, and clinically useful measures of strength, spasticity, contracture, gait, and motor function. Critical examination of impairment and functional level measures defines goals, guides treatment, and evaluates outcomes. With this approach, pediatric therapists can empower families to make well-informed decisions.https://www.mdpi.com/2227-9067/12/6/761cerebral palsyspasticitybotoxmotor functiongait |
| spellingShingle | Nancy Lennon Chris Church Jose J. Salazar-Torres Faithe Kalisperis Freeman Miller Jason J. Howard Changes in Motor Function in a Child with Cerebral Palsy Following Multiple Botulinum Toxin Injections: A Case Report Children cerebral palsy spasticity botox motor function gait |
| title | Changes in Motor Function in a Child with Cerebral Palsy Following Multiple Botulinum Toxin Injections: A Case Report |
| title_full | Changes in Motor Function in a Child with Cerebral Palsy Following Multiple Botulinum Toxin Injections: A Case Report |
| title_fullStr | Changes in Motor Function in a Child with Cerebral Palsy Following Multiple Botulinum Toxin Injections: A Case Report |
| title_full_unstemmed | Changes in Motor Function in a Child with Cerebral Palsy Following Multiple Botulinum Toxin Injections: A Case Report |
| title_short | Changes in Motor Function in a Child with Cerebral Palsy Following Multiple Botulinum Toxin Injections: A Case Report |
| title_sort | changes in motor function in a child with cerebral palsy following multiple botulinum toxin injections a case report |
| topic | cerebral palsy spasticity botox motor function gait |
| url | https://www.mdpi.com/2227-9067/12/6/761 |
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