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Indications and effects of botulinum toxin A for obstetric brachial plexus injury: a systematic literature review
Author(s) -
GOBETS DAVID,
BECKERMAN HELEEN,
GROOT VINCENT de,
VAN DOORNLOOGMAN MIRIAM H,
BECHER JULES G
Publication year - 2010
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.1469-8749.2009.03607.x
Subject(s) - medicine , brachial plexus injury , brachial plexus , cochrane library , cinahl , elbow , botulinum toxin , randomized controlled trial , medline , physical therapy , contracture , meta analysis , surgery , physical medicine and rehabilitation , psychological intervention , psychiatry , political science , law
Aim To give an overview of indications for the use of botulinum toxin A (BoNT‐A) treatment for children with obstetric brachial plexus injury (OBPI), and to present the best available evidence of the effectiveness of this treatment. Method Searches were performed in Cinahl, Cochrane Library, Embase, PubMed, and Web of Science, using the keywords ‘botulinum’ and ‘plexus’, to identify articles reporting on the use of BoNT‐A as a treatment for children with OBPI. Studies found through the references of related articles were also selected. Results Ten full‐text papers and six congress abstracts were included, involving 343 children. Four groups of indications could be identified: internal rotation/adduction contracture of the shoulder, limited active elbow flexion, limited active elbow extension, and pronation contracture of the lower arm. Overall, positive results were reported for all except the indication for limited active elbow extension. However, only one study was comparative in nature; all others were classified as having a low level of evidence. There was a large variation in outcome measures. Interpretation To provide better evidence for the already partly promising results of BoNT‐A treatment for children with OBPI, multicentre randomized controlled trials are needed.