Muscle volume alterations in spastic muscles immediately following botulinum toxin Type-A treatment in children with cerebral palsy
AIM: With evidence for an atrophic effect of botulinum toxin type A (BoNT-A) documented in typically developing muscles, this study investigated the immediate morphological alterations of muscles in children with cerebral palsy (CP) after BoNT-A treatment. METHOD: Fifteen children (10 males, five fe...
| Main Authors: | , , , , |
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| Format: | Journal Article |
| Published: |
Wiley-Blackwell Publishing Ltd.
2013
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| Online Access: | http://hdl.handle.net/20.500.11937/7671 |
| _version_ | 1848745436989358080 |
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| author | Williams, Sian Reid, S. Elliott, Catherine Shipman, P. Valentine, J. |
| author_facet | Williams, Sian Reid, S. Elliott, Catherine Shipman, P. Valentine, J. |
| author_sort | Williams, Sian |
| building | Curtin Institutional Repository |
| collection | Online Access |
| description | AIM: With evidence for an atrophic effect of botulinum toxin type A (BoNT-A) documented in typically developing muscles, this study investigated the immediate morphological alterations of muscles in children with cerebral palsy (CP) after BoNT-A treatment. METHOD: Fifteen children (10 males, five females; age range 5-11y, mean age 8y 5mo, SD 1y 10mo) with spastic diplegic CP [Gross Motor Function Classification System Levels I (n=9) and II (n=6)] receiving BoNT-A injections for spasticity management were included. None of the children was a first-time receiver of BoNT-A. Magnetic resonance imaging and Mimics software assessed muscle volume, timed 2 weeks before and 5 weeks after injection. All participants received BoNT-A bilaterally to the gastrocnemius muscle, and five participants also received BoNT-A bilaterally to the medial hamstring muscles. Functional assessment measures used were the 6-Minute Walk Test (6-MWT), the Timed Up and Go (TUG) test, and hand-held dynamometry. RESULTS: Whilst total muscle group volume of the injected muscle group remained unchanged, a 4.47% decrease in the injected gastrocnemius muscle volume (p=0.01) and a 3.96% increase in soleus muscle volume (p=0.02) was evident following BoNT-A. There were no statistically significant changes in function after BoNT-A as assessed by the TUG. There was also no statistically significant change in distance covered in the 6-MWT. Muscle strength, as assessed using hand-held dynamometry was also not statistically different after BoNT-A treatment.INTERPRETATION: Muscle volume decreases were observed in the injected muscle (gastrocnemius), with synergistic muscle hypertrophy that appeared to compensate for this decrement. The 4% to 5% decrease in the volume of BoNT-A injected muscles are not dramatic in comparison to reports in recent animal studies, and are a positive indication for BoNT-A, particularly as it also did not negatively alter function. |
| first_indexed | 2025-11-14T06:17:20Z |
| format | Journal Article |
| id | curtin-20.500.11937-7671 |
| institution | Curtin University Malaysia |
| institution_category | Local University |
| last_indexed | 2025-11-14T06:17:20Z |
| publishDate | 2013 |
| publisher | Wiley-Blackwell Publishing Ltd. |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | curtin-20.500.11937-76712019-07-08T04:27:29Z Muscle volume alterations in spastic muscles immediately following botulinum toxin Type-A treatment in children with cerebral palsy Williams, Sian Reid, S. Elliott, Catherine Shipman, P. Valentine, J. AIM: With evidence for an atrophic effect of botulinum toxin type A (BoNT-A) documented in typically developing muscles, this study investigated the immediate morphological alterations of muscles in children with cerebral palsy (CP) after BoNT-A treatment. METHOD: Fifteen children (10 males, five females; age range 5-11y, mean age 8y 5mo, SD 1y 10mo) with spastic diplegic CP [Gross Motor Function Classification System Levels I (n=9) and II (n=6)] receiving BoNT-A injections for spasticity management were included. None of the children was a first-time receiver of BoNT-A. Magnetic resonance imaging and Mimics software assessed muscle volume, timed 2 weeks before and 5 weeks after injection. All participants received BoNT-A bilaterally to the gastrocnemius muscle, and five participants also received BoNT-A bilaterally to the medial hamstring muscles. Functional assessment measures used were the 6-Minute Walk Test (6-MWT), the Timed Up and Go (TUG) test, and hand-held dynamometry. RESULTS: Whilst total muscle group volume of the injected muscle group remained unchanged, a 4.47% decrease in the injected gastrocnemius muscle volume (p=0.01) and a 3.96% increase in soleus muscle volume (p=0.02) was evident following BoNT-A. There were no statistically significant changes in function after BoNT-A as assessed by the TUG. There was also no statistically significant change in distance covered in the 6-MWT. Muscle strength, as assessed using hand-held dynamometry was also not statistically different after BoNT-A treatment.INTERPRETATION: Muscle volume decreases were observed in the injected muscle (gastrocnemius), with synergistic muscle hypertrophy that appeared to compensate for this decrement. The 4% to 5% decrease in the volume of BoNT-A injected muscles are not dramatic in comparison to reports in recent animal studies, and are a positive indication for BoNT-A, particularly as it also did not negatively alter function. 2013 Journal Article http://hdl.handle.net/20.500.11937/7671 10.1111/dmcn.12200 Wiley-Blackwell Publishing Ltd. unknown |
| spellingShingle | Williams, Sian Reid, S. Elliott, Catherine Shipman, P. Valentine, J. Muscle volume alterations in spastic muscles immediately following botulinum toxin Type-A treatment in children with cerebral palsy |
| title | Muscle volume alterations in spastic muscles immediately following botulinum toxin Type-A treatment in children with cerebral palsy |
| title_full | Muscle volume alterations in spastic muscles immediately following botulinum toxin Type-A treatment in children with cerebral palsy |
| title_fullStr | Muscle volume alterations in spastic muscles immediately following botulinum toxin Type-A treatment in children with cerebral palsy |
| title_full_unstemmed | Muscle volume alterations in spastic muscles immediately following botulinum toxin Type-A treatment in children with cerebral palsy |
| title_short | Muscle volume alterations in spastic muscles immediately following botulinum toxin Type-A treatment in children with cerebral palsy |
| title_sort | muscle volume alterations in spastic muscles immediately following botulinum toxin type-a treatment in children with cerebral palsy |
| url | http://hdl.handle.net/20.500.11937/7671 |