Short-term efficacy of botulinum neurotoxin for spastic cerebral palsy: A prospective and controlled study with parental feedback

Introduction: Cerebral palsy (CP) is a group of disorders that affect muscle movement, tone and coordination. The reduction of spastic muscular paralysis can be obtained by intramuscular injection of botulinum neurotoxin type A (BTX-A).Objectives: This study aimed to evaluate the antispastic effect of BTX-A in children with spastic CP and to estimate the parents’ opinion about the effectiveness of BTX-A therapy.Material and methods: A group of 40 children was divided into the study (n = 24, BTX-A + rehabilitation) and the control group (n = 16, rehabilitation). The modified Ashworth scale (MAS) was used to assess the level of muscle tone. A survey method was used to determine the subjective opinion of the children’s parents regarding the effectiveness of BTX-A.Results: The BTX-A injections significantly reduced the level of muscle spasticity in children with CP (5.5 points in the study vs. 2.8 points in control; p = 0.008). The analysis from the univariate linear regression model showed children from the study group (B = 1.38, p = 0.005) and older children (B = –0.30, p = 0.046) influence the difference in obtained MAS scores. The best effect was obtained by combining the BTX-A injection with rehabilitation. Parents positively opinionated the use of BTX-A injections to improve functioning, decrease hypertonia, and facilitate carrying. 83% of parents noticed an improvement in their child’s functioning after the first injection of BTX-A and 92% would recommend BTX-A injections for CP.Conclusions: BTX-A injections lead to a reduction in spasticity in children with CP. The effects of therapy are particularly noticeable at the beginning of the treatment, and the most effective in the youngest patients. BTX-A injections combined with intensive rehabilitation contribute to an improved functional level for children with spastic CP