Gait analysis to assess the effects of botulinum toxin type A treatment incerebral palsy: an open-label study in 10 children with equinus gait pattern

Botulinum toxin type A (BTX-A) injections induce a dose-related decrease in muscle tone and increased joint mobility in adults with spasticity and chi ldren with cerebral palsy. The aim of this study was to address the questio n of whether BTS-A-related improvements in joint mobility and muscle tone a re associated with changes in instrumental gait analysis in children with c erebral palsy. Ten children with cerebral palsy and equinus gait were given a single dose of BTX-A (5 U BOTOX(R)/kg body weight per leg) into the gast rocnemius muscles. At follow-up (mean, 32.6 days post-injection), a signifi cant (P < 0.05) increase in both passive and active ankle range of motion w as observed, together with a decrease in the modified Ashworth score. Instr umental gait analysis showed improvements in ankle and knee kinematics as w ell as in time-distance parameters, with a significant increase in step len gth observed (P < 0.05). Semi-quantitative analysis of rectified electromyo graphic (EMG) recordings of the tibialis anterior muscle during gait showed a reduction in EMG activity during the stance phase and an increase in EMG activity during the swing phase. This study demonstrated the benefits of B TX-A treatment in improving joint mobility and ambulatory function in child ren with cerebral palsy, and showed that changes in tibial anterior muscle activity as a result of BTX-A injections into the gastrocnemius muscle can be measured by instrumental gait analysis. Eur J Neurol 6 (suppl 4):S63-S67 (C) Lippincott Williams & Wilkins.