The role of botulinum toxin in the neuro-rehabilitation of young patients with brachial plexus birth palsy

Pediatric Rehabilitation
M T Desiato, B Risina

Abstract

To favour the active movements of the shoulder abductor/external rotator, elbow extensor and supinator muscles, through the partial inhibition of the uninvolved antagonistic muscles, in the Brachial Plexus birth Palsy (BPP). The type A Botulinum Neuro Toxin (BNT-Dysport, Ipsen) was injected in 50 outpatients (mean age: 4.7 +/- 3.4 years) with BPP according to the criteria: early and current neuro-rehabilitation (Reflex Locomotion-RL), age <14 years, no cognitive impairment. Repeat injections (1.9 +/- 0.8) were performed in 30 patients. The range of active movements increased at the maximal benefit phase, compared to the baseline values (p < 0.05-0.01). The gain of shoulder's abduction was directly related to the youngest age (r = 0.6). An expanded compliance of the injected muscles and a faster response to the RL, in respect to that experienced in the pre-BNT sessions, was detected. The Global Clinical Rating Scale disclosed the temporal profile of the clinical outcome, with step-like increases of the function in 70% of the patients, and a 'plateau' trait in the remaining ones (+29.8 +/- 10.5%). The video-taped recordings showed an improvement in the global movements. The employment of BNT in the management of young patients wi...Continue Reading

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