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serial casting cerebral palsy

Barbara Kelly, Marilyn MacKay-Lyons, Susan Berryman, Joe Hyndman, Ellen Wood
AIM: To study the effects of single versus serial casting post-Botulinum toxin A (BoNT-A) injections on hypoextensibility of triceps surae in children, 2-7 years old, with cerebral palsy and equinus gait. METHODS: A randomized, stratified, parallel, two-group trial was conducted at a pediatric health center with assessments at baseline, precast, postcast and, 1-, 2-, and 6-month follow-ups. One week following BoNT-A injections into triceps surae muscle, a single below-knee cast (n = 10) or 3 serial casts (n = 10) were applied for 3 weeks...
May 17, 2018: Physical & Occupational Therapy in Pediatrics
Jonathan J Noble, Emily Chruscikowski, Nicola R D Fry, Andrew P Lewis, Martin Gough, Adam P Shortland
BACKGROUND: Individuals with cerebral palsy have smaller muscle volumes normalised to body mass than their typically developing peers. The aim of this study is to investigate the relationship between lower limb muscle volume and body mass in young people with bilateral cerebral palsy and their typically developing peers. METHODS: Twenty-five participants with bilateral cerebral palsy (aged 14.7±3.0 years, GMFCS level I-III) and 25 of their typically developing peers (aged 16...
December 29, 2017: BMC Neurology
Nickolas J Nahm, H Kerr Graham, Mark E Gormley, Andrew G Georgiadis
PURPOSE OF REVIEW: The review provides an update on the treatment of hypertonia in cerebral palsy, including physical management, pharmacotherapy, neurosurgical, and orthopedic procedures. RECENT FINDINGS: Serial casting potentiates the effect of Botulinum neurotoxin A injections for spasticity. Deep brain stimulation, intraventricular baclofen, and ventral and dorsal rhizotomy are emerging tools for the treatment of dystonia and/or mixed tone. The long-term results of selective dorsal rhizotomy and the timing of orthopedic surgery represent recent advances in the surgical management of hypertonia...
February 2018: Current Opinion in Pediatrics
Alper I Dai, Abdullah T Demiryürek
The purpose of this study was to examine whether combination therapy of serial casting and botulinum toxin type A injection can further enhance the effects of botulinum toxin type A in children with cerebral palsy with scissoring of both legs. This study was a prospective and randomized trial. The children were divided into 2 groups, one of which received serial casting after botulinum toxin type A (n = 40), and the other which only received botulinum toxin type A (n = 40). Serial casting started 3 weeks after the botulinum toxin type A...
June 2017: Journal of Child Neurology
Nigar Dursun, Tugba Gokbel, Melike Akarsu, Erbil Dursun
OBJECTIVE: Physical therapy (PT) and botulinum toxin-A (BTX-A) injections are widely used in the treatment of spastic equinus foot due to cerebral palsy. The aim of this study was to show effects of intermittent serial casting (SC) in addition to standard treatment on spasticity, passive range of motion (PROM), and gait. DESIGN: Fifty-one ambulatory patients, treated by BTX-A to plantar flexor muscles, were randomly assigned to casting or control groups in a 2:1 ratio...
April 2017: American Journal of Physical Medicine & Rehabilitation
Tandy Hastings-Ison, Christine Blackburn, Barry Rawicki, Michael Fahey, Pam Simpson, Richard Baker, Kerr Graham
AIM: We compared two botulinum toxin A (BoNT-A) injection frequency regimens, 12-monthly versus 4-monthly, for spastic equinus in a randomized clinical trial. The primary outcome measure was passive ankle dorsiflexion. METHOD: Forty-two ambulant children with spastic equinus, secondary to cerebral palsy (23 males and 19 females; mean age 3y 6mo, SD 13mo; GMFCS levels I [n=20], II [n=19], III [n=3]) were randomized to receive either 12-monthly or 4-monthly BoNT-A injections to the calf, over a 26-month period...
July 2016: Developmental Medicine and Child Neurology
Hui Taek Kim, Jong Seok Oh, Jong Seo Lee, Tae Hoon Lee
BACKGROUND: The risk of various complications after Achilles tendon lengthening is mainly related to the length of surgical exposure and the lengthening method. A comprehensive technique to minimize the complications is required. METHODS: The treatment of Achilles tendon tightness in 57 patients (95 ankles) were performed by using a short transverse incision on a skin crease of the heel and by Z-lengthening of the tendon. In the severe cases, two or three transverse incisions were required for greater lengthening of the tendon, and a serial cast or Ilizarov apparatus was applied for the gradual correction...
June 2014: Clinics in Orthopedic Surgery
Matthias C M Klotz, Sebastian I Wolf, Daniel Heitzmann, Michael W Maier, Frank Braatz, Thomas Dreher
Primary genu recurvatum (GR) is less investigated and data presenting the prevalence among patients with bilateral spastic cerebral palsy (BSCP) is lacking in the literature. Equinus is mentioned as one of the main underlying factors in GR, but its influence on the severity and onset type of GR is mainly unanswered, yet. Hence, the purpose of this retrospective study was to assess the prevalence of GR in a large sample size in children with BSCP and to investigate sagittal plane kinematics to evaluate the influence of equinus on different GR types using data of three-dimensional gait analysis...
June 2014: Research in Developmental Disabilities
Megan Thorley, Samantha Donaghey, Priya Edwards, Lisa Copeland, Megan Kentish, Kim McLennan, Jayne Lindsley, Laura Gascoigne-Pees, Leanne Sakzewski, Roslyn N Boyd
BACKGROUND: Children with cerebral palsy (CP) whom are non-ambulant are at risk of reduced quality of life and poor health status. Severe spasticity leads to discomfort and pain. Carer burden for families is significant. This study aims to determine whether intramuscular injections of botulinum toxin A (BoNT-A) combined with a regime of standard therapy has a positive effect on care and comfort for children with CP whom are non-ambulant (GMFCS IV/V), compared with standard therapy alone (cycle I), and whether repeated injections with the same regime of adjunctive therapy results in greater benefits compared with a single injecting episode (cycle II)...
August 9, 2012: BMC Pediatrics
Sook Joung Lee, In Young Sung, Dae Hyun Jang, Jin Hwa Yi, Jin Ho Lee, Ju Seok Ryu
OBJECTIVE: To identify the effect of serial casting combined with Botulinum toxin type A (BTX-A) injection on spastic equinus foot. METHOD: Twenty-nine children with cerebral palsy who had equinus foot were recruited from the outpatient clinic of Rehabilitation Medicine. The children were divided into 2 groups, one of which received serial casting after BTX-A injection, and the other which only received BTX-A injection. Serial casting started 3 weeks after the BTX-A injection, and was changed weekly for 3 times...
June 2011: Annals of Rehabilitation Medicine
Lawrence P Lai, Susan Reeves, Beth P Smith, Kat Kolaski, Jeffrey S Shilt
Spasticity, a common symptom accompanying cerebral palsy (CP), can severely affect patients' function and cause disability in childhood. Intrathecal baclofen (ITB) therapy is a widely used treatment to reduce spasticity in quadriparetic CP patients. Likewise, adults sustaining strokes and subsequent spastic hemiplegic have proven excellent candidates as well from ITB therapy. However, data on ITB treatment in pediatric patients with hemiplegic CP are lacking. This is the first report to present such a case...
2008: Journal of Pediatric Rehabilitation Medicine
Adrienne Harvey, Jan Willem Gorter
PURPOSE: This paper outlines the application of video gait analysis (VGA) for children with cerebral palsy (CP) when full instrumented three dimensional gait analysis (3DGA) is either not indicated or not available. SCOPE: Gait analysis is an important part of the assessment of ambulant children with CP for diagnosing gait deviations and for evaluating change. Many regard 3DGA as the most informative method of assessing gait, however, it is not always accessible, practical, or feasible and the detail obtained is not always indicated...
March 2011: Gait & Posture
Eun Sook Park, Dong-Wook Rha, Jun Ki Yoo, Sun Mi Kim, Won Hyuk Chang, Sang Hyuk Song
PURPOSE: The purpose of this paper is to test the hypothesis that combination therapy of serial cast and botulinum toxin type A (BTX-A) injection can further enhance the effects of a BTX-A injection in ambulant children with cerebral palsy (CP) who have an equinus foot. MATERIALS AND METHODS: Children in group A (30 legs of 21 children) received a serial casting application after an injection of BTX-A, and children in group B (25 legs of 17 children) received only a BTX-A injection...
July 2010: Yonsei Medical Journal
Ryan D Muchow, Walker D Flannery, James A Miedaner, Kenneth J Noonan, James J McCarthy
We present the case of a 24-year-old woman with spastic diplegic cerebral palsy who developed left lower extremity compartment syndrome after serial casting to treat an equinus contracture. To our knowledge, this represents the first case of compartment syndrome that has occurred from cast application to treat a deformity. The cast was the second placed in the treatment series and was removed 18 hours later because of increased pain. The clinical picture progressed despite the cast being removed. Accordingly, the patient presented to the emergency department with uncontrollable pain and a peroneal nerve deficit...
April 2010: Archives of Physical Medicine and Rehabilitation
Kenneth Huh, Susan A Rethlefsen, Tishya A L Wren, Robert M Kay
BACKGROUND: Although equinus is more common in cerebral palsy (CP), the prevalence of calcaneal gait (CG) has been reported at more than 30% among patients with CP, even in the absence of prior surgical intervention. The goal of this study was to identify patient characteristics predictive of the development of CG in patients without prior triceps surae lengthening. METHODS: Gait data were reviewed for 58 participants with bilateral involvement owing to CP (116 limbs) who had 2 gait analysis tests with no triceps surae lengthening between tests...
April 2010: Journal of Pediatric Orthopedics
Samuel R Pierce, Laura A Prosser, Richard T Lauer
OBJECTIVE: To examine the relationship between passive torque, reflex activity, co-contraction, and age during the assessment of spasticity of knee flexors and extensors in children with spastic diplegic cerebral palsy (CP). DESIGN: Retrospective. SETTING: Pediatric orthopedic hospital. PARTICIPANTS: Children (N=36) with spastic diplegic CP. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Spasticity of the knee flexors and knee extensors (as measured by peak passive torque, mean passive torque, reflex activity of the medial hamstrings, reflex activity of vastus lateralis, and co-contraction) was assessed during passive movements completed using an isokinetic dynamometer with concurrent electromyography...
March 2010: Archives of Physical Medicine and Rehabilitation
Emily S Ho, Trisha Roy, Derek Stephens, Howard M Clarke
PURPOSE: Elbow flexion contractures are a common sequela in obstetric brachial plexus palsy. The etiology and best management of these contractures is unclear. Nonsurgical treatment involving serial casting and splinting is supported in the literature. The purpose of this study is to evaluate the effectiveness of serial casting and splinting of elbow flexion contractures in children with obstetric brachial plexus palsy. METHODS: A retrospective review of children with obstetric brachial plexus palsy who participated in serial casting and splinting for an elbow flexion contracture was conducted...
January 2010: Journal of Hand Surgery
Barbara Kelly, Marilyn J MacKay-Lyons, Susan Berryman, Joe Hyndman, Ellen Wood
PURPOSE: The purpose of this study was to investigate feasibility of an assessment protocol for a trial of post-Botox casting to treat equinus gait in cerebral palsy. METHODS: Ten children (ages, 26-75 months) were recruited. Nine were assessed 1 week before botulinum toxin-A injections and reassessed 1 week after removal of the final cast. The assessment protocol included Modified Ashworth Scale (MAS), Modified Tardieu Scale (MTS), Gross Motor Function Measure-66 (GMFM-66), Pediatric Evaluation of Disability Inventory (PEDI), and GAITRite...
2008: Pediatric Physical Therapy
Shweta Jain, Navnendra Mathur, Mrinal Joshi, Rajeshwari Jindal, Sunil Goenka
OBJECTIVE: Cerebral palsy (CP) is a range of non progressive syndromes of posture and motor impairment due to an insult to developing brain. Spasticity and incoordination are major causes of disability in these children which can be managed by different modalities like casting, botulinum toxin, surgery etc. Cast application in spastic equinus is a well established procedure in CP but cast application in patients of CP with bilateral involvement of hip, knee and ankle is not document. METHODS: A study was conducted on 22 children of spastic CP in age range of 3-8 years with bilateral involvement of hip, knee and ankle in 20 cases, hip and ankle in one case and only ankle in one case...
October 2008: Indian Journal of Pediatrics
Christopher John Newman, Ann Kennedy, Michael Walsh, Timothy O'Brien, Bryan Lynch, Owen Hensey
BACKGROUND: 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. METHODS: 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...
December 2007: Journal of Pediatric Orthopedics
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