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DOI: 10.1055/s-0044-1788544
The Effectiveness of Botulinum Toxin Injections to the Extremities in the Pediatric Population with Severe Cerebral Palsy: A Systematic Review
Funding None.Abstract
The purpose of this review was to examine the effectiveness of botulinum toxin injections to the upper and lower extremities reported in studies of pediatric participants with severe cerebral palsy on improving ease of care, pain, and motor function. PubMed, CINAHL, and Web of Science were searched using combinations of cerebral palsy and various types and abbreviations of botulinum toxin. Additionally, reference lists and citations of reviewed studies were searched. The results of 25 studies were reviewed: three randomized controlled trials (RCTs) and 22 nonrandomized studies of interventions involving only a botulinum toxin-treated group. Seven studies focused solely on the targeted population while the remainder included participants of a wider range of severity. Ease of care was generally reported as improved. The effect on pain was variable: postoperative pain was significantly reduced in one RCT but not in another; nonspecific pain was improved in some cases; and joint specific pain was decreased in one study. Motor function changes were the most frequently evaluated in the studies without a comparison group; however, only a few used standardized assessment tools, e.g., Gross Motor Function Measure, and found pre- to postinjection improvement. The described findings need to be viewed cautiously due to the low level of rigorousness of most of the reviewed studies.
Publikationsverlauf
Eingereicht: 05. April 2024
Angenommen: 23. Juni 2024
Artikel online veröffentlicht:
16. August 2024
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References
- 1 Rosenbaum P, Paneth N, Leviton A. et al. A report: the definition and classification of cerebral palsy April 2006. Dev Med Child Neurol Suppl 2007; 109: 8-14
- 2 Gorter JW, Rosenbaum PL, Hanna SE. et al. Limb distribution, motor impairment, and functional classification of cerebral palsy. Dev Med Child Neurol 2004; 46 (07) 461-467
- 3 Goldsmith S, McIntyre S, Smithers-Sheedy H. et al; Australian Cerebral Palsy Register Group. An international survey of cerebral palsy registers and surveillance systems. Dev Med Child Neurol 2016; 58 (Suppl. 02) 11-17
- 4 Palisano RJ, Rosenbaum P, Bartlett D, Livingston MH. Content validity of the expanded and revised Gross Motor Function Classification System. Dev Med Child Neurol 2008; 50 (10) 744-750
- 5 Palisano R, Rosenbaum P, Walter S, Russell D, Wood E, Galuppi B. Development and reliability of a system to classify gross motor function in children with cerebral palsy. Dev Med Child Neurol 1997; 39 (04) 214-223
- 6 Cosgrove AP, Corry IS, Graham HK. Botulinum toxin in the management of the lower limb in cerebral palsy. Dev Med Child Neurol 1994; 36 (05) 386-396
- 7 Durkin MS, Benedict RE, Christensen D. et al. Prevalence of cerebral palsy among 8-year-old children in 2010 and preliminary evidence of trends in its relationship to low birthweight. Paediatr Perinat Epidemiol 2016; 30 (05) 496-510
- 8 Elkamil AI, Andersen GL, Skranes J, Lamvik T, Vik T. Botulinum neurotoxin treatment in children with cerebral palsy: a population-based study in Norway. Eur J Paediatr Neurol 2012; 16 (05) 522-527
- 9 Franzén M, Hägglund G, Alriksson-Schmidt A. Treatment with Botulinum toxin A in a total population of children with cerebral palsy - a retrospective cohort registry study. BMC Musculoskelet Disord 2017; 18 (01) 520
- 10 Hägglund G, Hollung SJ, Ahonen M. et al. Treatment of spasticity in children and adolescents with cerebral palsy in Northern Europe: a CP-North registry study. BMC Neurol 2021; 21 (01) 276
- 11 Pin TW, Elmasry J, Lewis J. Efficacy of botulinum toxin A in children with cerebral palsy in Gross Motor Function Classification System levels IV and V: a systematic review. Dev Med Child Neurol 2013; 55 (04) 304-313
- 12 Barwood S, Baillieu C, Boyd R. et al. Analgesic effects of botulinum toxin A: a randomized, placebo-controlled clinical trial. Dev Med Child Neurol 2000; 42 (02) 116-121
- 13 Page MJ, Moher D, Bossuyt PM. et al. PRISMA 2020 explanation and elaboration: updated guidance and exemplars for reporting systematic reviews. BMJ 2021; 372 (160) n160
- 14 Sterne JAC, Savović J, Page MJ. et al. RoB 2: a revised tool for assessing risk of bias in randomised trials. BMJ 2019; 366: l4898
- 15 Sterne JAC, Hernán MA, Reeves BC. et al. ROBINS-I: a tool for assessing risk of bias in non-randomised studies of interventions. BMJ 2016; 355: i4919
- 16 Copeland L, Edwards P, Thorley M. et al. Botulinum toxin A for nonambulatory children with cerebral palsy: a double blind randomized controlled trial. J Pediatr 2014; 165 (01) 140-146.e4
- 17 Will E, Magill N, Arnold R. et al. Preoperative botulinum neurotoxin A for children with bilateral cerebral palsy undergoing major hip surgery: a randomized double-blind placebo-controlled trial. Dev Med Child Neurol 2019; 61 (09) 1074-1079
- 18 Akyuz M, Dursun N, Gokbel T, Cekmece C, Dursun E. Improved sitting balance in children with CP: body functions to activity and participation. J Pediatr Neurol 2022; 20: 386-391
- 19 Bonikowski M, Chrościnska-Krawczyk M, Pyrzanowska W. Functional improvement of young children with cerebral palsy treated with integrated/intensive rehabilitation and botulinum toxin injections. Neurol Neurochir Pol 2023; 57 (02) 183-188
- 20 Coutinho dos Santos LH, Bufara Rodrigues DC, Simões de Assis TR, Bruck I. Effective results with botulinum toxin in cerebral palsy. Pediatr Neurol 2011; 44 (05) 357-363
- 21 Dursun N, Akyuz M, Gokbel T. et al. GMFCS level improvement in children with cerebral palsy treated with repeat botulinum toxin injections and intensive rehabilitation: a retrospective study. J Pediatr Rehabil Med 2022; 15 (01) 107-112
- 22 El O, Peker O, Kosay C, Iyilikci L, Bozan O, Berk H. Botulinum toxin A injection for spasticity in diplegic-type cerebral palsy. J Child Neurol 2006; 21 (12) 1009-1012
- 23 Fattal-Valevski A, Domenievitz D, Giladi N, Wientroub S, Hayek S. Long-term effect of repeated injections of botulinum toxin in children with cerebral palsy: a prospective study. J Child Orthop 2008; 2 (01) 29-35
- 24 Fattal-Valevski A, Giladi N, Domanievitz D. et al. Parameters for predicting favorable responses to botulinum toxin in children with cerebral palsy. J Child Neurol 2002; 17 (04) 272-277
- 25 Kareem AA, Al-Auqhi TFR. Botulinum toxin type A for treatment of children with spastic cerebral palsy. Iraqi J Community Med 2011; 24 (Supp1): 39-46
- 26 Koman LA, Mooney III JF, Smith B, Goodman A, Mulvaney T. Management of cerebral palsy with botulinum-A toxin: preliminary investigation. J Pediatr Orthop 1993; 13 (04) 489-495
- 27 Lee Y, Lee S, Jang J, Lim J, Ryu JS. Effect of botulinum toxin injection on the progression of hip dislocation in patients with spastic cerebral palsy: a pilot study. Toxins (Basel) 2021; 13 (12) 872
- 28 Linder M, Schindler G, Michaelis U. et al. Medium-term functional benefits in children with cerebral palsy treated with botulinum toxin type A: 1-year follow-up using gross motor function measure. Eur J Neurol 2001; 8 (Suppl. 05) 120-126
- 29 Lundy CT, Doherty GM, Fairhurst CB. Botulinum toxin type A injections can be an effective treatment for pain in children with hip spasms and cerebral palsy. Dev Med Child Neurol 2009; 51 (09) 705-710
- 30 Mall V, Heinen F, Kirschner J. et al. Evaluation of botulinum toxin A therapy in children with adductor spasm by gross motor function measure. J Child Neurol 2000; 15 (04) 214-217
- 31 Meholjic A, Madjar D. Application of botulinum toxin in treatment of spasticity and functional improvements for children suffering from cerebral palsy. Med Arh 2010; 64 (06) 359-361
- 32 Mesterman R, Gorter JW, Harvey A. et al. Botulinum toxin type A in children and adolescents with severe cerebral palsy: a retrospective chart review. J Child Neurol 2014; 29 (02) 210-213
- 33 Papavasiliou AS, Rapidi CA, Filiopoulos C, Rizou C, Skouteli HN. Evaluation of a multimodal management of prematurity-related spasticity. Pediatr Neurol 2006; 35 (06) 400-407
- 34 Park G-y. Effects of botulinum toxin A treatment in cerebral palsy. J of Korean Acad of Rehabil Med 1997; 21: 390-398
- 35 Sarigeçili E, Sezgin M, Hanbara Ü, Derici Yildirim D, Okuyaz Ç. Botulinum toxin-A injection for hip adductor spasticity in children with cerebral palsy: a retrospective study. J PMR Sci 2021; 24: 277-283
- 36 Vles GF, de Louw AJ, Speth LA. et al. Visual Analogue Scale to score the effects of Botulinum Toxin A treatment in children with cerebral palsy in daily clinical practice. Eur J Paediatr Neurol 2008; 12 (03) 231-238
- 37 Weigl DM, Arbel N, Katz K, Becker T, Bar-On E. Botulinum toxin for the treatment of spasticity in children: attainment of treatment goals. J Pediatr Orthop B 2007; 16 (04) 293-296
- 38 Wong V. Use of botulinum toxin injection in 17 children with spastic cerebral palsy. Pediatr Neurol 1998; 18 (02) 124-131
- 39 Rosenbaum PL, Walter SD, Hanna SE. et al. Prognosis for gross motor function in cerebral palsy: creation of motor development curves. JAMA 2002; 288 (11) 1357-1363
- 40 Howell K, Selber P, Graham HK, Reddihough D. Botulinum neurotoxin A: an unusual systemic effect. J Paediatr Child Health 2007; 43 (06) 499-501
- 41 Montastruc J, Marque P, Moulis F. et al. Adverse drug reactions of botulinum neurotoxin type A in children with cerebral palsy: a pharmaco-epidemiological study in VigiBase. Dev Med Child Neurol 2017; 59 (03) 329-334
- 42 Wong C, Pedersen SA, Kristensen BB, Gosvig K, Sonne-Holm S. The effect of botulinum toxin A injections in the spine muscles for cerebral palsy scoliosis, examined in a prospective, randomized triple-blind study. Spine 2015; 40 (23) E1205-E1211
- 43 Swinney CM, Bau K, Burton KLO, O'Flaherty SJ, Bear NL, Paget SP. Severity of cerebral palsy and likelihood of adverse events after botulinum toxin A injections. Dev Med Child Neurol 2018; 60 (05) 498-504