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Journal of the Korean Academy of Rehabilitation Medicine 2001;25(4):594-600.
The Effects of Botulinum Toxin A on Upper Limb Function in Children with Cerebral Palsy.
Kim, Hyeon Sook , Hwang, Ji Hye , Lee, Peter KW , Jung, Sung Hyun , Park, Heui Dong , Cho, Eun Hee , Shim, Jong Sup , Kim, Jong Moon
1Department of Physical Medicine and Rehabilitation, Sungkyunkwan University School of Medicine.
2Department of Orthopedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine.
3Department of Physical Medicine and Rehabilitation, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine.
보툴리눔 독소 주사가 뇌성마비 환아의 상지기능에 미치는 영향
김현숙, 황지혜, 이강우, 정승현, 박희동, 조은희, 심종섭1, 김종문2
성균관대학교 의과대학 삼성서울병원 재활의학교실, 1정형외과학교실, 2강북삼성병원 재활의학교실
Abstract

Objective
To evaluate the efficacy of botulinum toxin type A in the treatment of spasticitc and dystonic upper limbs in a group of cerebral palsy children


Method
Eighteen children with cerebral palsy who did not have fixed contractures in the wrist and hand were enrolled (mean age 9.0 years; range 6∼15). Measurements were obtained before and at 1 and 3 months after botulinum toxin A injections. Assessments included spasticity (modified Ashworth scale), range of motion of thumb and functional assessments including Melbourne assessment of unilateral upper limb function and Jebsen Taylor hand function test. Hand and forearm muscles were injected with 1∼3 u/kg botulinum toxin.


Results
Spasticity measured by modified Ashworth scale decreased by 1 month and diminished spasticity continued for 3 months. Range of motion of thumb increased by 1 and 3 months. In Jebsen hand function test, patients showed functional improvements in item 6 (lifting light weight object) and item 7 (lifting heavy object). Melbourne assessment of unilateral upper limb function scores improved from a mean value of 92 at baseline to a mean value of 101 at 1 month and a mean value of 105 at 3 months.


Conclusion
Botulinum toxin A would be helpful in some selected cerebral palsy patients with upper limb dysfunction. But further research including randomized controlled study is needed on the use of botulinum toxin A to improve function.

Key Words: Botulinum toxin A, Spasticity, Cerebral palsy, Children, Hand function


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