Article

AIM: To investigate the effects of repeated botulinum toxin A (BoNT-A) injections
combined with occupational therapy, including a splint, compared with
occupational therapy alone on hand function in children with unilateral spastic
cerebral palsy (USCP), in all International Classification of Functioning,
Disability and Health (ICF) domains. METHOD: This was a randomized controlled
study, population-based and evaluator-blinded for primary outcome (October 2004
to September 2010). Twenty children (14 males; median age 3y 1mo) with USCP,
recruited at a rehabilitation centre in Sweden, were assigned to one of two
parallel groups using concealed allocation. In the course of one year, 10
children received occupational therapy, while 10 received repeated BoNT-A plus
occupational therapy (BoNT-A/OT). Primary outcome (Assisting Hand Assessment
[AHA]), and secondary outcome measures (range of movement [ROM], and Canadian
Occupational Performance Measure), were measured at baseline, 3, 6, 9, and 12
months. RESULTS: AHA revealed a superior effect in the BoNT-A/OT group at 12
months: 6 out of 10 improved compared with 1 out of 10 in the occupational
therapy group (p<0.03).
A 95% Peskun exact confidence interval for the difference
in proportions is given as 0.01 to 0.81. Secondary outcomes improved in both
groups. INTERPRETATION: Repeated BoNT-A/OT appeared superior to occupational
therapy alone for bimanual performance in young children with USCP. Active ROM
and goal performance improved in both groups.
CI - (c) 2015 Mac Keith Press.

Langue : ANGLAIS