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    Botulinum toxin a for nonambulatory children with cerebral palsy: A double blind randomized controlled trial

    Access Status
    Fulltext not available
    Authors
    Copeland, L.
    Edwards, P.
    Thorley, M.
    Donaghey, S.
    Gascoigne-Pees, L.
    Kentish, M.
    Lindsley, J.
    McLennan, K.
    Sakzewski, L.
    Boyd, Roslyn
    Date
    2014
    Type
    Journal Article
    
    Metadata
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    Citation
    Copeland, L. and Edwards, P. and Thorley, M. and Donaghey, S. and Gascoigne-Pees, L. and Kentish, M. and Lindsley, J. et al. 2014. Botulinum toxin a for nonambulatory children with cerebral palsy: A double blind randomized controlled trial. Journal of Pediatrics. 165 (1): pp. 140-146.
    Source Title
    Journal of Pediatrics
    DOI
    10.1016/j.jpeds.2014.01.050
    ISSN
    0022-3476
    School
    School of Occupational Therapy and Social Work
    URI
    http://hdl.handle.net/20.500.11937/40225
    Collection
    • Curtin Research Publications
    Abstract

    Objectives: To examine the efficacy and safety of intramuscular botulinum toxin A (BoNT-A) to reduce spasticity and improve comfort and ease of care in nonambulant children with cerebral palsy (CP). Study design: Nonambulant children with CP (n = 41; Gross Motor Function Classification System level IV = 3, level V = 38; mean age 7.1 years, range 2.3-16 years, 66% male) were randomly allocated to receive either intramuscular BoNT-A injections (n = 23) or sham procedure (n = 18) combined with therapy. The analysis used generalized estimating equations with primary outcome the Canadian Occupational Performance Measure (COPM) at 4 weeks postintervention and retention of effects at 16 weeks. Adverse events (AE) were collected at 2, 4, and 16 weeks by a physician masked to group allocation. Results: There were significant between group differences favoring the BoNT-A-treated group on COPM performance at 4 weeks (estimated mean difference 2.2, 95% CI 0.8, 3.5; P = .002) and for COPM satisfaction (estimated mean difference 2.2, 95% CI 0.5, 3.9; P = .01). These effects were retained at 16 weeks for COPM satisfaction (estimated mean difference 1.8, 95% CI 0.1, 3.5; P = .04). There were more mild AE at 4 weeks for the BoNT-A group (P = .002), however, there were no significant between-group differences in the reporting of moderate and serious AE. Conclusions: In a double-blind randomized sham-controlled trial, intramuscular BoNT-A and therapy were effective for improving ease of care and comfort for nonambulant children with CP. There was no increase in moderate and severe AE in the children who had BoNT-A injections compared with the sham group.

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