Neurorehabilitation with versus without resistance training after botulinum toxin treatment in children with cerebral palsy: A randomized pilot study

TY - JOUR

T1 - Neurorehabilitation with versus without resistance training after botulinum toxin treatment in children with cerebral palsy

T2 - A randomized pilot study

AU - Bandholm, Thomas Quaade

AU - Jensen, Bente Rona

AU - Nielsen, Lone M

AU - Rasmussen, Helle

AU - Bencke, Jesper

AU - Curtis, Derek

AU - Pedersen, Søren A

AU - Sonne-Holm, Stig

N1 - CURIS 2012 5200 085

PY - 2012

Y1 - 2012

N2 - Objective: To compare the effects of physical rehabilitation with (PRT) and without (CON) progressive resistance training following treatment of spastic plantarflexors with botulinum toxin type A (BoNT) in children with cerebral palsy (CP). Methods: Fourteen children with CP performed supervised PRT (n=7) or CON (n=7) two times per week for 12 weeks, following the BoNT-treatment. Outcome measurements were performed at baseline (pre BoNT), and 4 and 12 weeks post BoNT. They consisted of: ankle muscle function (maximal torque and submaximal torque steadiness of isometric ankle dorsi-and plantarflexion and associated ankle muscle [EMG] activity), gait function (3-dimensional gait analysis), balance function (sway analysis), gross motor function (GMFM-66), and spasticity (modified Ashworth). Results: Submaximal torque control (torque steadiness) of isometric dorsiflexion improved similarly in the two groups, and the improvement was related to the reduction in antagonist (soleus) co-activity (P< 0.05). Maximal plantarflexion torque increased after PRT, whereas a reduction was seen after CON (P< 0.05). No changes in function were observed. Conclusions: Both types of physical rehabilitation in combination with BoNT-treatment improved antagonist (ankle dorsiflexion) torque-control to the same extent -which was related to the reduction in antagonist co-activity -but only rehabilitation with PRT increased maximal plantarflexion torque.

AB - Objective: To compare the effects of physical rehabilitation with (PRT) and without (CON) progressive resistance training following treatment of spastic plantarflexors with botulinum toxin type A (BoNT) in children with cerebral palsy (CP). Methods: Fourteen children with CP performed supervised PRT (n=7) or CON (n=7) two times per week for 12 weeks, following the BoNT-treatment. Outcome measurements were performed at baseline (pre BoNT), and 4 and 12 weeks post BoNT. They consisted of: ankle muscle function (maximal torque and submaximal torque steadiness of isometric ankle dorsi-and plantarflexion and associated ankle muscle [EMG] activity), gait function (3-dimensional gait analysis), balance function (sway analysis), gross motor function (GMFM-66), and spasticity (modified Ashworth). Results: Submaximal torque control (torque steadiness) of isometric dorsiflexion improved similarly in the two groups, and the improvement was related to the reduction in antagonist (soleus) co-activity (P< 0.05). Maximal plantarflexion torque increased after PRT, whereas a reduction was seen after CON (P< 0.05). No changes in function were observed. Conclusions: Both types of physical rehabilitation in combination with BoNT-treatment improved antagonist (ankle dorsiflexion) torque-control to the same extent -which was related to the reduction in antagonist co-activity -but only rehabilitation with PRT increased maximal plantarflexion torque.

U2 - 10.3233/nre-2012-0756

DO - 10.3233/nre-2012-0756

M3 - Journal article

C2 - 22672941

SN - 1053-8135

VL - 30

SP - 277

EP - 286

JO - NeuroRehabilitation

JF - NeuroRehabilitation

IS - 4

ER -