A pilot study of delayed versus immediate serial casting after botulinum toxin injection for partially reducible spastic equinus

Journal of Pediatric Orthopedics
Christopher John NewmanOwen Hensey

Abstract

Serial casting is often prescribed after botulinum toxin injections to improve joint ranges of motion and to potentiate the decrease in hypertonia. The aim of this study was to compare delayed versus immediate serial casting as an adjunct to botulinum toxin therapy for partially reducible spastic equinus. Twelve children who presented spastic equinus associated with mild gastrosoleus contracture took part. Five of them had a diagnosis of spastic diplegia, whereas 7 had a diagnosis of congenital hemiplegia. Children were randomized to immediate serial casting (same day) or delayed serial casting (4 weeks later) after botulinum toxin injection to their gastrosolei. Casts were replaced weekly for 3 weeks. Three children complained of pain that required recasting in the immediate casting group versus none in the delayed casting group (P = 0.08). At 3 months, there was a 27-degree improvement in the fast dorsiflexion angle (Tardieu R1) in the delayed casting group versus 17 degrees in the immediate casting group (P = 0.029). At 6 months, a 19-degree improvement persisted in the delayed group compared with 11 degrees in the immediate group (P = 0.010). There is a clear benefit in delaying serial casting after the injection of botulin...Continue Reading

References

Feb 1, 1987·Physical Therapy·R W Bohannon, M B Smith
Jan 1, 1997·Movement Disorders : Official Journal of the Movement Disorder Society·R EleopraD De Grandis
Feb 20, 2002·European Journal of Neurology : the Official Journal of the European Federation of Neurological Societies·K DesloovereP De Cock
Feb 20, 2002·European Journal of Neurology : the Official Journal of the European Federation of Neurological Societies·R N Boyd, R M Hays
Jan 25, 2003·Journal of Paediatrics and Child Health·P J Flett
Nov 4, 2004·The Journal of Bone and Joint Surgery. American Volume·Robert M KayDavid L Skaggs
Sep 6, 2005·Developmental Medicine and Child Neurology·Jeffrey D AckmanUNKNOWN Shriners Hospitals BTX-A Study Group

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Citations

Jun 9, 2009·Seminars in Pediatric Neurology·Ann Tilton
Sep 10, 2015·Physiotherapy Research International : the Journal for Researchers and Clinicians in Physical Therapy·Kylee Tustin, Anita Patel
Mar 4, 2009·The Journal of Bone and Joint Surgery. American Volume·Young-Jo Kim, Kenneth J Noonan
Feb 2, 2017·The Cochrane Database of Systematic Reviews·Lisa A HarveyKarl Schurr
Oct 9, 2019·The Cochrane Database of Systematic Reviews·Francesco C BlumettiJosé A Pinto
Nov 15, 2008·The Journal of Bone and Joint Surgery. American Volume·Thorsten M SeylerL Andrew Koman
May 15, 2018·Physiotherapy Canada. Physiothérapie Canada·Joan Leung, Katarina Stroud

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