Articles Vol. 65 No. CĐ11- HN Chấn thương Chỉnh hình-TPHCM 02/12/2024

23. EVALUATION OF IMPROVEMENT IN LOWER LIMB MUSCLE RIGIDITY IN CHILDREN WITH CEREBRAL PALSY USING BOTULINUM TOXIN TYPE A IN CHILDREN’S HOSPITAL 1

Vo Quang Dinh Nam1,2, Lam Minh Chinh3,4
1 Hospital for Traumatology and Orthopaedics
2 Bệnh viện Chấn thương Chỉnh hình Thành phố Hồ Chí Minh
3 Children's Hospital 1
4 Bệnh viện Nhi Đồng 1
Corresponding author: namvqd@gmail.com
DOI: 10.52163/yhc.v65iCD11.1758
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Keywords
BoNT-A cerebral palsy muscle stiffness
Abstract

Background: Children's Hospital 1 has been treating muscle stiffness in children with cerebral palsy using BoNT-A since 2018, but there has yet to be a comprehensive study summarizing and evaluating its actual effectiveness and existing challenges in order to refine the treatment protocol.

Research Objectives: To determine the rate of improvement in muscle stiffness symptoms in the lower limbs due to cerebral palsy using Botulinum Toxin Type A injections.

Subjects and Methods: This is a descriptive comparative study conducted before and after intervention on children diagnosed with “lower limb muscle stiffness due to cerebral palsy” treated with BoNT-A injections at the Orthopedic Department of Children's Hospital No. 1. A total sampling method was employed. Results were assessed using the modified Ashworth scale, GMFCS, and measuring the angle of spasticity at the following time points: 2 weeks, 1.5 months, 3 months, and 6 months post-injection.

Results: After 1.5 months post-injection, no cases were recorded at levels 2 and 3; primarily, cases were observed at level 1, accounting for 92.5%. The Ashworth score after 3 months indicated that the majority of children (60%) were at level 0, with 40% at level 1. After 6 months, a higher percentage (62.5%) was recorded at level 0. The GMFCS score before injection, after 2 weeks, and after 1.5 months showed that 72.5% of subjects were at level I, while 27.5% were in level II. After 6 months, 100% of subjects were classified as level I in the GMFCS. Before injection, 75% of subjects had a mean spasticity angle of 8.7 degrees. After 6 months, 75% of subjects had a mean spasticity angle of 12.75 degrees.

Conclusion: The increased use of BoNT-A for children with cerebral palsy exhibiting lower limb muscle stiffness is recommended. This method has proven effective in reducing muscle stiffness and improving motor function.

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