The Effect of Foot Serial Casting Along with Botulinum Toxin Type-A Injection on Spasticity in Children with Cerebral Palsy

Background & Aims: The goal of this study was to determine the effect of foot serial casting along with botulinum toxin type-A injection on spasticity in children with cerebral palsy. Methods: This study was a randomized clinical trial performed as a pre-post, double blind study. It was performed on ۲۵ children with hemiplegia and diplegia (۲-۸ years) in Tehran city, who were referred to valiasr rehabilitation foundation. Participants were chosen by simple randomized sampling and were matched for age, Gross Motor Function Classification System (GMFCS) and type. They were randomly divided into two groups. The first group (n=۱۳) underwent BTX-A injection alone and the second group (n=۱۲) had BTX-A injection and foot serial casting after the injection. Clinical assessments were done using the GMFCS and Modified Ashworth Scale before and at ۱, ۳, ۶ and ۱۲ months after the interventions. Data were analyzed by Wilcoxon signed rank test and mann-whitney U. Results: Comparison of two groups in regard to the right and left knee spasticity at, ۱, ۳, ۶ and ۱۲ months after injection showed no significant difference in comparison to those before interventions. Furthermore, comparison of right and left ankle spasticity before injection with that at ۱, and ۳ months follow ups did not show statistically significant difference, but significant differences were found when compared with ۶ and ۱۲ month follow-ups (P<۰.۰۵) Conclusion: It seems, one of the proper approaches to reduce spasticity in children with cerebral palsy is foot serial casting along with botulinum toxin type-A injection and it can decrease the muscle tone when applied more than six months.

The Effect of Foot Serial Casting Along with Botulinum Toxin Type-A Injection on Spasticity in Children with Cerebral Palsy Keywords:

Cerebral palsy , Botulinum toxin type A , Muscle spasticity , Casts , Occupational Therapy