Motor Recovery of Lower Limbs in Cerebral Palsy with Botulinum Toxin and Physioteraphy (GJIDD)- Juniper Publishers
Introduction: The gait is a central function in the neuropsychological development of the normal child and in neuromotor diseases such as PCI. Spasticity is a major problem that prevents the development of motor functions remaining in these patients, thus producing a limited participation in recreational and sports activities and social activities. The synergistic action of the FET and the BTX-A can be a valuable aid, as the transient inhibition of muscle spasticity, can allow the subject to learn to reorganize through the rehabilitation intervention movement in a different way, in order to reduce the functional limitations in the lower limbs allowing a greater motor skills and thus a better quality of life.
Material and methods: 2 groups of 15 patients (PCI form paraparetic) mean age 9.3±3.2 years. Patients at recruiting visit (T0) had spastic hypertonia borne muscles of the lower limbs with a tendency to be crossed scissor gait and foot equinus. All patients were evaluated with the MAS scale, WeeFim and evaluation miometrica muscle AM, GM and GL; Group 1 was treated with botulinum toxin type A Xeomin® in muscles AM, GM, GL and soleus and subsequent FKT other day, group 2 instead performed only FKT to three times a week. At each visit (T0=injection, T1=1 month, 3 months=T2, T3=4 months, T4=5 months, T5 inj. =6 months, T6=7 months, t7=9 months, T8=10 months, T9=11 months, T10 inj. =12 months), all patients were evaluated with indicated scales.
Result: All the assessments of the MAS, the WeeFim and myometric measurement have shown that the effect of the toxin affects positively on spasticity and motor skills of patients, resulting in a greater postural stability and an improvement in gait paretic spastic, reducing equinus foot, knee flexion and adduction of the thighs, thus improving the range of motion and finally the limb deformities.
Conclusion: The combined action of BTX-A and FKT evaluated with stairs MAS and WeeFim and with the objective measurement of myometric tone showed that these patients after treatment are able to use compartments engines in a more functional and above all intentional, consistent with its willingness to perform a particular action, thus ensuring greater integration opportunities in classroom-recreational-sports with greater social integration and thus better quality of life.
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