Adductor spasticity in children with cerebral palsy and treatment with botulinum toxin type A: the parents' view of functional outcome

Botulinum toxin type A (BTX-A) has been used successfully to manage spastic ity in children with cerebral palsy, Little has been done to evaluate treat ment outcome and satisfaction from the patients' and parents' points of vie w The aim of this study was to investigate the parents' perceptions of the benefits of BTX-A on movement disorders in children with cerebral palsy. Tw enty-six children with adductor spasticity were enrolled into an open-label , prospective study. Patients received intramuscular injections of BTX-A, a nd assessments of joint mobility (passive range of motion), degree of spast icity (Modified Ashworth Scale) and functional benefit (Gross Motor Functio n Measure) were made before and 12-18 weeks after treatment. Parents' asses sment of treatment outcomes were evaluated using a standardised questionnai re. BTX-A was shown to be effective in reducing muscular hyperactivity and functional limitations. Parents' satisfaction with the treatment outcome wa s high, For non-ambulatory patients, the reported benefits included facilit ation of daily care, ease of positioning and reduction of pain. For patient s who were disabled to a lesser extent, improvements in gait and posture in cluded sitting with improved comfort, standing for longer periods of time a nd/or walking longer distances. The parents' responses supported the impres sions of the therapists, demonstrating that BTX-A produced beneficial effec ts on daily activities, according to both objective measures and parents' o bservation. Eur J Neurol 6 (suppl 4):S47-S50 (C) Lippincott Williams & Wilk ins.