THE EFFECTS OF COMPREHENSIVE REHABILITATION AFTER BOTULINUM TOXIN A INJECTION ON BASIC GAIT PARAMETE

1
THE EFFECTS OF COMPREHENSIVE REHABILITATION AFTER
BOTULINUM TOXIN A INJECTION ON BASIC GAIT
PARAMETERS OF CEREBRAL PALSY PATIENTS

• U Gurª, AO Uckardes b, S Yilmazturkb, F Altintasc

ªMetin Sabanci Spastic Children Center, Istanbul,
Turkey. bErol Sabanci Motion and Gait Analysis
Center and Metin Sabanci Spastic Children Center,
Istanbul, Turkey. cYeditepe University,
Istanbul, Turkey.
OBJECTIVE This study was performed to examine
the effects of comprehensive rehabilitation after
botulinum toxin A (Bt-A) injection on basic gait
parameters of cerebral palsy patients by using
computerized gait analysis.
METHODS The study included 18 children (5 girls
and 13 boys the mean age of 4.77) who attended
rehabilitation programs at Metin Sabanci Spastic
Children Center. Bt-A injections were applied to
the gastrocnemius muscles in 28 lower extremities
with dynamic equinus deformity with/without
dynamic knee flexion deformity. Basic gait
parameters were made before, at 6 weeks, and at 6
months after botulinum toxin A injection, by
using the EVaRT 4.0 hardware-software and
OrthoTrak 5.0.3 software systems (Motion Analysis
Corp.) at Erol Sabanci Motion and Gait Analysis
Center. The treatment protocol included daily
Neurodevelopmental Therapy (NDT),
stretching-strengthening exercises, and a
specific therapy program based on every subjects
individual requirements. Wilcoxon Two-Related
Samples Tests were used to determine the benefits
of the treatment.
Stretching of Plantarflexors
Standing up from Sitting and Controlling Erect
Posture
Heel Contact
Stretching of Plantarflexors Actively
RESULTS In this study, the gait cycle was
divided into 7 phases. Initial contact phase was
contributed into the loading response phase. The
results are given in the table. When all of the
basic gait parameters (step width, stride length,
cadence, velocity, first and second double
support times, single support times, stance and
swing phases) obtained before and 6 weeks after
botulinum toxin A injections were compared, no
statistically significant differences were found.
However, there were statistically significant
improvements when the comparison data of before
and 6 months, and of 6 weeks and 6 months after
the injections were examined.
CONCLUSION This study supports that intensive,
individually based, active and long-term physical
therapy program applied after Bt-A injection is
strongly needed in order to obtain functional
gains.
uku-gur_at_hotmail.com EACD 2007 GRONINGEN
NETHERLAND