Efficacy of botulinum toxin A, serial casting, and combined treatment for spastic equinus: A retrospective analysis

Allan M. Glanzman, Heakyung Kim, Kartik Swaminathan, Teresa Beck

Research output: Contribution to journalArticlepeer-review

50 Scopus citations

Abstract

Botulinum toxin type A (BTX-A), serial casting, and combined treatment for spastic equinus were compared by chart review. Fifty-five patients with diplegia (n=21), hemiplegia (n=17), quadriplegia (n=6), and other diagnoses (n=11) were reviewed. Thirty-one patients had Gross Motor Function Classification System (GMFCS) scores of I or II, 10 had a GMFCS score of III, and eight had GMFCS scores of IV or V (for six there were no available data). Mean age was 7 years 1 month (SD 4 y 8mo). The combined group showed a significantly greater increase in passive range of motion (ROM) of the ankle joint in comparison with BTX-A alone (p=0.0002), with a mean of 17° (SD 11.2) versus 5° (SD 6.7), and casting alone showed a significantly greater increase in comparison with BTX-A alone (p=0.0001), with a mean of 15° (SD 4.5) versus 5° (SD 6.7). With cast number controlled, change in ROM after casting with and without BTX-A was not significantly different (p=0.37). There was no significant difference between casting with or without BTX-A, and both improved ROM to a greater degree than BTX-A alone. Casting demonstrated a significantly more robust impact on range of motion than BTX-A alone.

Original languageEnglish (US)
Pages (from-to)807-811
Number of pages5
JournalDevelopmental Medicine and Child Neurology
Volume46
Issue number12
DOIs
StatePublished - Dec 2004
Externally publishedYes

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Developmental Neuroscience
  • Clinical Neurology

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