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A randomized controlled trial comparing botulinum toxin A dosage in the upper extremity of children with spasticity
Author(s) -
Kawamura Anne,
Campbell Kent,
LamDamji Sophie,
Fehlings Darcy
Publication year - 2007
Publication title -
developmental medicine and child neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.658
H-Index - 143
eISSN - 1469-8749
pISSN - 0012-1622
DOI - 10.1111/j.1469-8749.2007.00331.x
Subject(s) - medicine , biceps , randomized controlled trial , spasticity , anesthesia , analysis of variance , upper limb , grip strength , botulinum toxin , physical therapy , spastic , cerebral palsy , surgery
This study compared the effects of low and high doses of botulinum toxin A (BTX‐A) to improve upper extremity function. Thirty‐nine children (22 males, 17 females) with a mean age of 6 years 2 months (SD 2y 9mo) diagnosed with spastic hemiplegia or triplegia were enrolled into this double‐blind, randomized controlled trial. The high‐dose group received BTX‐A in the following doses: biceps 2U/kg, brachioradialis 1.5U/kg, common flexor origin 3U/kg, pronator teres 1.5U/kg, and adductor/opponens pollicis 0.6U/kg to a maximum of 20U. The low‐dose group received 50% of this dosage. Outcomes were measured at baseline and at 1 and 3 months after injection, and results were analyzed with a repeated‐measures analysis of variance. There was no significant difference between the low‐dose and high‐dose groups in upper extremity function over the 3‐month period as measured by the Quality of Upper Extremity Skills Test ( F [1,37]=0.18, p =0.68). There was no difference between the groups in the Pediatric Evaluation of Disability Inventory Self Care Domain ( F [1,37]=0.05, p =0.83). Although grip strength decreased over the 3‐month period, there was no difference between groups ( F [1,32]=0.45, p =0.51). These findings indicate that there is no difference in hand and arm function between a low dose and a high dose of BTX‐A at 1 and 3 months after injection. This information can be used to guide dosage of BTX‐A for the management of upper extremity spasticity in children.