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Rehabilitation of spasticity and related problems in childhood cerebral palsy
Author(s) -
Flett PJ
Publication year - 2003
Publication title -
journal of paediatrics and child health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.631
H-Index - 76
eISSN - 1440-1754
pISSN - 1034-4810
DOI - 10.1046/j.1440-1754.2003.00082.x
Subject(s) - spasticity , medicine , rhizotomy , cerebral palsy , rehabilitation , botulinum toxin , physical medicine and rehabilitation , physical therapy , upper motor neuron , dorsum , surgery , disease , pathology , amyotrophic lateral sclerosis , anatomy
Spasticity is one part of the upper motor neuron syndrome, but it is a widespread problem in cerebral palsy; it is debilitating, affects function and can lead to musculoskeletal complications. Significant advances have occurred in antispasticity management (and related musculoskeletal problems) in children with cerebral palsy during the past 5−10 years. Botulinum toxin A has been the most outstanding treatment advance; it is relatively long‐lasting, easy to administer, reversible, has a favourable side‐effect profile and is highly useful for focal spasticity. There is an emerging role for intrathecal baclofen in Australia. Despite being available and practised in North America for years, selective dorsal rhizotomy has not been popular in Australia. The use of orthopaedic surgery has significantly altered in recent years. There is still a place for oral drug treatment, including some newer agents and the potential for combination treatment with other modalities. The role of physical therapy in defining disability, assessing function, undertaking biomechanical assessment and providing mobility aids/casting/orthoses and motor training/stretching exercises is critical for the success of medical and surgical interventions. From an Australian perspective, the purpose of the present review is to provide a critical review of therapies available for spasticity associated with childhood cerebral palsy.