1
|
Yilmaz N, Turker D, Aytar A, Yemisci OU, Aytar A. The Acute Effects of Kinesio Taping on Drooling in Children with Cerebral Palsy: A Randomized Placebo-Controlled Trial. Dev Neurorehabil 2024:1-8. [PMID: 38967352 DOI: 10.1080/17518423.2024.2374080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Accepted: 06/25/2024] [Indexed: 07/06/2024]
Abstract
INTRODUCTION This study purpose of determining the short-term effects of kinesio taping on drooling in children with cerebral palsy (CP). METHODS CP were randomly divided into 3 groups as the kinesio tape (n = 16), sham tape (n = 16), and control (n = 16) groups. The drooling severity and frequency were assessed with the Drooling Severity and Frequency Scale, and the amount of saliva was measured by the 5-minute drooling quotient. All outcome measurements were repeated for all children at the baseline, after 45 minutes, and after 2 days of application. RESULTS There was a significant decrease found in drooling severity, frequency, and amount in the kinesio taping group (p < .05). There was no significant difference in the sham taping and control groups (p > .05). CONCLUSION The use of kinesio tape in drooling reduced drooling severity, frequency, and amount.
Collapse
Affiliation(s)
- Nilsah Yilmaz
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Tokat Gaziosmanpaşa University, Tokat, Turkey
| | - Duygu Turker
- Gulhane Faculty of Physiotherapy and Rehabilitation, University of Health Sciences, Ankara, Turkey
| | - Ayca Aytar
- Vocational School of Health Sciences, Physiotherapy Program, Baskent University, Ankara, Turkey
| | - Oya Umit Yemisci
- Department of Physical and Rehabilitation Medicine, Ankara Oncology Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Aydan Aytar
- Gulhane Faculty of Physiotherapy and Rehabilitation, University of Health Sciences, Ankara, Turkey
| |
Collapse
|
2
|
Crisafulli S, Ciccimarra F, Khan Z, Maccarrone F, Trifirò G. Understanding Clinical Effectiveness and Safety Implications of Botulinum Toxin in Children: A Narrative Review of the Literature. Toxins (Basel) 2024; 16:306. [PMID: 39057946 PMCID: PMC11281390 DOI: 10.3390/toxins16070306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2024] [Revised: 06/20/2024] [Accepted: 07/01/2024] [Indexed: 07/28/2024] Open
Abstract
Since its first approval by the Food and Drug Administration in 1989 for strabismus, botulinum toxin indications of use have been widely expanded. Due to its anticholinergic properties, this toxin is currently approved in adult patients for the treatment of a wide range of neuromuscular, otolaryngologic, orthopedic, gastrointestinal, and urologic disorders. Approved pediatric indications of use include the treatment of blepharospasm associated with dystonia, strabismus, lower-limb spasticity, focal spasticity in patients with cerebral palsy, and neurogenic detrusor overactivity. Alongside these approved indications, botulinum toxin is extensively used off-label. Although several clinical studies have shown that botulinum toxin is effective and well-tolerated in children, uncertainties persist regarding its long-term effects on growth and appropriate dosing in this population. As such, further research is needed to better define the botulinum toxin risk-benefit profile and expand approved uses in pediatrics. This narrative review aimed to provide a broad overview of the evidence concerning the clinical effectiveness and safety of BoNT with respect to its principal authorized and non-authorized pediatric therapeutic indications, as well as to describe perspectives on its future use in children.
Collapse
Affiliation(s)
| | - Francesco Ciccimarra
- Department of Diagnostics and Public Health, University of Verona, 37124 Verona, Italy; (F.C.); (F.M.)
| | - Zakir Khan
- Department of Pharmacy Practice, Riphah Institute of Pharmaceutical Sciences, Riphah International University, Gulberg Green Campus, Islamabad 44000, Pakistan;
| | - Francesco Maccarrone
- Department of Diagnostics and Public Health, University of Verona, 37124 Verona, Italy; (F.C.); (F.M.)
| | - Gianluca Trifirò
- Department of Diagnostics and Public Health, University of Verona, 37124 Verona, Italy; (F.C.); (F.M.)
| |
Collapse
|
3
|
Oad H, Maltezeanu A, da Silva SD, Daniel SJ. Onabotulinum Toxin A (BoNT-A) for Drooling in Children: A Systematic Review and Meta-Analysis. Laryngoscope 2024; 134:3012-3017. [PMID: 38294288 DOI: 10.1002/lary.31277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 12/19/2023] [Accepted: 12/22/2023] [Indexed: 02/01/2024]
Abstract
INTRODUCTION Sialorrhea, also known as drooling, hypersalivation, or ptyalism, has a significant impact on the medical and psychosocial well-being of children. Onabotulinum toxin A (BoNT-A) is the most commonly used botulinum toxin worldwide for the treatment of sialorrhea in children. OBJECTIVES To conduct a comprehensive systematic review and meta-analysis to assess the clinical efficacy and potential adverse effects of BoNT-A as a treatment for drooling in children. METHODS Cochrane, Embase, and Medline databases were systematically searched (up to May 2023). Out of 535 identified publications, 20 were found eligible for inclusion. A systematic review and meta-analysis were performed to determine the efficacy of BoNT-A treatment in children in reducing the frequency and severity of drooling. RESULTS Out of the 20 studies included, a meta-analysis was conducted on the complete dataset of eight studies involving 131 patients. BoNT-A was found to significantly decrease the severity of drooling in patients with sialorrhea (standardized mean difference [SMD], -2.07; 95% confidence interval [CI], -2.91 to -1.23; p < 0.0001) when compared with the conditions before injections using random-effects models. Six studies out of 20 reported dysphagia as an adverse effect after injection. Other side effects included thickness of saliva and pain at the site of injection. CONCLUSION BoNT-A is a clinically effective therapy that improves drooling severity in children with sialorrhea. Although there were some adverse side effects reported, they were transient and not severe. Future studies are needed to further evaluate the best techniques and to identify the ideal dosages required to achieve the optimal outcomes. Laryngoscope, 134:3012-3017, 2024.
Collapse
Affiliation(s)
- Haresh Oad
- Department of Otolaryngology-Head and Neck Surgery, McGill University, Montreal, Quebec, Canada
| | - Alix Maltezeanu
- Department of Otolaryngology-Head and Neck Surgery, McGill University, Montreal, Quebec, Canada
| | - Sabrina D da Silva
- Department of Otolaryngology-Head and Neck Surgery, McGill University, Montreal, Quebec, Canada
| | - Sam J Daniel
- Department of Otolaryngology-Head and Neck Surgery, McGill University, Montreal, Quebec, Canada
| |
Collapse
|
4
|
Orriëns LB, van der Burg JJW, van den Hoogen FJA, Willemsen MAAP, van Hulst K, Erasmus CE. The when, why, and how of using glycopyrronium to diminish drooling in children with neurodevelopmental disabilities: Implications for clinical practice. Eur J Paediatr Neurol 2024; 51:24-31. [PMID: 38776696 DOI: 10.1016/j.ejpn.2024.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 05/12/2024] [Indexed: 05/25/2024]
Abstract
BACKGROUND Despite the established efficacy of glycopyrronium bromide in reducing drooling among children with neurodevelopmental disabilities, evidence on its impact on the daily lives of children and parents and effectiveness in a real-world setting are scarce, especially among long-term users. This study explored timing and duration of glycopyrronium treatment, effect and impact on daily life, and occurrence of side effects to inform clinical practice. METHODS This was a retrospective cohort study at a national referral centre for drooling, including 61 children with nonprogressive neurodevelopmental disabilities, treated with glycopyrronium for anterior and/or posterior drooling between 2011 and 2021. Data were obtained from medical records and supplemented by structured telephone interviews with parents. RESULTS Anterior drooling severity decreased in 82% of the included children. Changes in the impact of drooling on burden of care, social interaction, and self-esteem were reported in 55%, 31%, and 36%, respectively. Side effects were noted for 71% of cases, yet only 36% of parents deemed these as outweighing the positive impact of treatment. A substantial majority (77%) of the included children were long-term users (≥6 months). Among these, 38% of parents reported decreasing effectiveness and 27% noticed more prominent side effects over time. CONCLUSIONS Glycopyrronium demonstrated potential in mitigating the impact of drooling on daily life, although variations were observed in the specific aspects and extent of improvement. The real-world context of our study provides important insights for refining clinical practices, emphasizing the need for balanced consideration of treatment benefits and potential side effects to facilitate shared decision-making.
Collapse
Affiliation(s)
- Lynn B Orriëns
- Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Amalia Children's Hospital, Department of Paediatric Neurology, Division of Paediatrics, Nijmegen, the Netherlands.
| | - Jan J W van der Burg
- Sint Maartenskliniek, Department of Paediatric Rehabilitation, Ubbergen, the Netherlands; Radboud University Nijmegen, School of Pedagogical and Educational Science, Nijmegen, the Netherlands
| | - Frank J A van den Hoogen
- Radboud University Medical Centre, Department of Otorhinolaryngology and Head and Neck Surgery, Nijmegen, the Netherlands
| | - Michèl A A P Willemsen
- Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Amalia Children's Hospital, Department of Paediatric Neurology, Division of Paediatrics, Nijmegen, the Netherlands
| | - Karen van Hulst
- Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Amalia Children's Hospital, Department of Rehabilitation, Nijmegen, the Netherlands
| | - Corrie E Erasmus
- Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Amalia Children's Hospital, Department of Paediatric Neurology, Division of Paediatrics, Nijmegen, the Netherlands
| |
Collapse
|
5
|
Silva MA, da Silveira MMF, Pedrosa BRV, Dos Santos RTNT, de Farias ZBBM, Sobral APV. A systematic review of the perspectives of botulinum toxin use on the quality of life of neurological patients with drooling. Clin Oral Investig 2024; 28:322. [PMID: 38758415 DOI: 10.1007/s00784-024-05718-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Accepted: 05/08/2024] [Indexed: 05/18/2024]
Abstract
OBJECTIVE To investigate the effectiveness of botulinum toxin in the salivary glands of patients with neurological impairment and drooling and its impact on the quality of life. MATERIALS AND METHODS This systematic review was registered with the International Prospective Register of Systematic Reviews (CRD 42,023,435,242) and conducted using the Preferred Reporting Items for Systematic Reviews and Meta-analyses. An electronic search was performed in the PubMed/MEDLINE, Embase, Scopus, Cochrane Library, and clinical trial databases until August 2023, no language restriction. Cohort studies and randomized clinical trials of patients diagnosed with drooling and neurological impairment who used botulinum toxin on the salivary gland were included, which evaluated subjective quality of life parameters. The risk of bias was assessed using the Joanna Briggs Institute Critical Appraisal Checklist and Risk of Bias 2 tools. The certainty of the evidence was analyzed using the Grading of Recommendations Assessment, Development, and Evaluation approach. RESULTS Eight studies involving 317 patients were included. All studies, through subjective parameters, suggested the effectiveness of botulinum toxin in reducing drooling, resulting in an improvement in the quality of life. Three studies demonstrated improvements in swallowing and four in cases of respiratory diseases. Two clinical trials had a high risk of bias, whereas one had low risk. The five cohort studies that were evaluated had a high risk of bias. The certainty of the evidence was considered low. CONCLUSIONS Based on the patient/caregivers' perception of improvement in drooling, dysphagia, and respiratory symptoms, it can be inferred that botulinum toxin application reduces subjective drooling in neurologically compromised patients. Its impact contributes to the general well-being and quality of life. CLINICAL RELEVANCE Injection of botulinum toxin into the salivary glands can be considered an alternative technique to surgical or medicinal approaches in reducing drooling. It is effective, less invasive and without significant side effects. It promotes a positive impact on the well-being and quality of life of neurological patients.
Collapse
Affiliation(s)
- Michelle Almeida Silva
- Faculdade de Odontologia, Universidade de Pernambuco, Campus Santo Amaro, Pernambuco, Brasil.
- Programa de Pós-Graduação em Odontologia, Universidade de Pernambuco, Pernambuco Recife (PE), Brasil.
- , Rua Coronel Barata 52, João Pessoa, 58025-300, Paraíba, Brasil.
| | - Márcia Maria Fonseca da Silveira
- Faculdade de Odontologia, Universidade de Pernambuco, Campus Santo Amaro, Pernambuco, Brasil
- Programa de Pós-Graduação em Odontologia, Universidade de Pernambuco, Pernambuco Recife (PE), Brasil
| | - Bruna Rafaele Vieira Pedrosa
- Faculdade de Odontologia, Universidade de Pernambuco, Campus Santo Amaro, Pernambuco, Brasil
- Programa de Pós-Graduação em Odontologia, Universidade de Pernambuco, Pernambuco Recife (PE), Brasil
| | - Rebeka Thiara Nascimento Thiara Dos Santos
- Faculdade de Odontologia, Universidade de Pernambuco, Campus Santo Amaro, Pernambuco, Brasil
- Programa de Pós-Graduação em Odontologia, Universidade de Pernambuco, Pernambuco Recife (PE), Brasil
| | - Zilda Betânia Barbosa Medeiros de Farias
- Faculdade de Odontologia, Universidade de Pernambuco, Campus Santo Amaro, Pernambuco, Brasil
- Programa de Pós-Graduação em Odontologia, Universidade de Pernambuco, Pernambuco Recife (PE), Brasil
| | - Ana Paula Veras Sobral
- Faculdade de Odontologia, Universidade de Pernambuco, Campus Santo Amaro, Pernambuco, Brasil
- Programa de Pós-Graduação em Odontologia, Universidade de Pernambuco, Pernambuco Recife (PE), Brasil
| |
Collapse
|
6
|
Ha TAN, Shih MC, Lambert EM. Comparing botulinum toxin and 4-duct ligation for Sialorrhea in children - A systematic review. Am J Otolaryngol 2024; 45:104119. [PMID: 38043299 DOI: 10.1016/j.amjoto.2023.104119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 11/19/2023] [Indexed: 12/05/2023]
Abstract
INTRODUCTION Sialorrhea or drooling can result in physical and psychosocial complications, such as aspiration and social isolation. Treatment options include botulinum toxin into the salivary glands and 4-duct ligation (i.e., simultaneous ligation of the bilateral parotid and submandibular ducts). This systematic review aimed to compare the efficacy and complication rates of botulinum toxin and 4-duct ligation for the treatment of drooling in children. METHODS Following PRISMA guidelines, PubMed, Embase, Web of Science, and Cochrane Library were searched from inception through June 17, 2021 for studies examining the efficacy of botulinum toxin or 4-duct ligation for drooling in children. Data were summarized by pooled counts, percentages, and means. Complication rates were compared by a chi-squared test. RESULTS A total of 22 studies (n = 606) examining botulinum toxin and 5 studies (n = 124) examining 4-duct ligation were included. From 12 botulinum toxin studies (n = 211), mean drooling frequency and severity scores was 7.5 at baseline. Mean difference from baseline was -2.6 (n = 92) at 4 weeks follow-up, -2.1 at 8 weeks (n = 41), -2.1 at 12 weeks (n = 56), and - 2.1 at 16 weeks (n = 58). From 4 4-duct ligation studies (n = 103), mean baseline drooling frequency and severity score was 8.4. Mean difference was -3.7 at mean follow-up of 35.6 months (n = 103). Eighteen botulinum studies (n = 343) recorded 53 (15.5 %) complications, including thickened saliva (n = 9), dysphagia (n = 4), and cheek abscesses (n = 4). Four 4-duct ligation studies (n = 108) recorded 25 (23.1 %) complications, including parotid gland swelling (n = 4), aspiration pneumonia (n = 3), and oxygen desaturation (n = 3). There was no statistically significant difference in complication rates between botulinum toxin and four-duct ligation (p = 0.065). CONCLUSION Botulinum toxin injection and 4-duct ligation are both effective in improving sialorrhea in children and have comparable complication rates.
Collapse
Affiliation(s)
- Tu-Anh N Ha
- Baylor College of Medicine, Bobby R. Alford Department of Otolaryngology, 1977 Butler Boulevard, Houston, TX 77030, USA; Texas Children's Hospital, Department of Surgery, Division of Otolaryngology, Houston, TX, USA
| | - Michael C Shih
- Baylor College of Medicine, Bobby R. Alford Department of Otolaryngology, 1977 Butler Boulevard, Houston, TX 77030, USA; Texas Children's Hospital, Department of Surgery, Division of Otolaryngology, Houston, TX, USA
| | - Elton M Lambert
- Baylor College of Medicine, Bobby R. Alford Department of Otolaryngology, 1977 Butler Boulevard, Houston, TX 77030, USA; Texas Children's Hospital, Department of Surgery, Division of Otolaryngology, Houston, TX, USA.
| |
Collapse
|
7
|
Orriëns LB, van Hulst K, van der Burg JJW, van den Hoogen FJA, Willemsen MAAP, Erasmus CE. Comparing the evidence for botulinum neurotoxin injections in paediatric anterior drooling: a scoping review. Eur J Pediatr 2024; 183:83-93. [PMID: 37924348 PMCID: PMC10858158 DOI: 10.1007/s00431-023-05309-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 10/19/2023] [Accepted: 10/24/2023] [Indexed: 11/06/2023]
Abstract
Paediatric anterior drooling has a major impact on the daily lives of children and caregivers. Intraglandular botulinum neurotoxin type-A (BoNT-A) injections are considered an effective treatment to diminish drooling. However, there is no international consensus on which major salivary glands should be injected to obtain optimal treatment effect while minimizing the risk of side effects. This scoping review aimed to explore the evidence for submandibular BoNT-A injections and concurrent submandibular and parotid (i.e. four-gland) injections, respectively, and assess whether outcomes could be compared across studies to improve decision making regarding the optimal initial BoNT-A treatment approach for paediatric anterior drooling. PubMed, Embase, and Web of Science were searched to identify relevant studies (until October 1, 2023) on submandibular or four-gland BoNT-A injections for the treatment of anterior drooling in children with neurodevelopmental disabilities. Similarities and differences in treatment, patient, outcome, and follow-up characteristics were assessed. Twenty-eight papers were identified; 7 reporting on submandibular injections and 21 on four-gland injections. No major differences in treatment procedures or timing of follow-up were found. However, patient characteristics were poorly reported, there was great variety in outcome measurement, and the assessment of side effects was not clearly described. Conclusion: This review highlights heterogeneity in outcome measures and patient population descriptors among studies on paediatric BoNT-A injections, limiting the ability to compare treatment effectiveness between submandibular and four-gland injections. These findings emphasize the need for more extensive and uniform reporting of patient characteristics and the implementation of a core outcome measurement set to allow for comparison of results between studies and facilitate the optimization of clinical practice guidelines. What is Known: • There is no international consensus on which salivary glands to initially inject with BoNT-A to treat paediatric drooling. What is New: • Concluding on the optimal initial BoNT-A treatment based on literature is currently infeasible. There is considerable heterogeneity in outcome measures used to quantify anterior drooling.and clinical characteristics of children treated with intraglandular BoNT-A are generally insufficiently reported. • Consensus-based sets of outcome measures and patient characteristics should be developed and implemented.
Collapse
Affiliation(s)
- Lynn B Orriëns
- Department of Paediatric Neurology, Division of Paediatrics, Donders Institute for Brain, Cognition and Behaviour, Amalia Children's Hospital, Radboud University Medical Center, Nijmegen, the Netherlands.
| | - Karen van Hulst
- Department of Rehabilitation, Donders Institute for Brain, Cognition and Behaviour, Amalia Children's Hospital, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Jan J W van der Burg
- Department of Paediatric Rehabilitation, Sint Maartenskliniek, Ubbergen, the Netherlands
- School of Pedagogical and Educational Science, Radboud University Nijmegen, Nijmegen, the Netherlands
| | - Frank J A van den Hoogen
- Department of Otorhinolaryngology and Head and Neck Surgery, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Michèl A A P Willemsen
- Department of Paediatric Neurology, Division of Paediatrics, Donders Institute for Brain, Cognition and Behaviour, Amalia Children's Hospital, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Corrie E Erasmus
- Department of Paediatric Neurology, Division of Paediatrics, Donders Institute for Brain, Cognition and Behaviour, Amalia Children's Hospital, Radboud University Medical Center, Nijmegen, the Netherlands
| |
Collapse
|
8
|
Wang J, Yue L, Chen Z, Bai B, Chen C. Effect of Hospital-Family Rehabilitation Intervention on Walking Function and Lower Limb Surface Electromyography in Children with Cerebral Palsy. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2022; 2022:7034670. [PMID: 35720026 PMCID: PMC9200566 DOI: 10.1155/2022/7034670] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 05/06/2022] [Accepted: 05/24/2022] [Indexed: 11/18/2022]
Abstract
Objective To explore the effect of hospital-family rehabilitation intervention on walking function and lower limb surface electromyography in children with cerebral palsy (CP). Methods About 100 children with CP treated in our hospital from February 2019 to April 2021 were enrolled. The patients were randomly assigned into control group and study group. The control group received routine intervention, and the study group received hospital-family rehabilitation intervention. The intervention effect, GMFM88 scale score, IMMG value, CR value, lower limb surface EMG value, and compliance of gastrocnemius muscle and tibialis anterior muscle were compared. Results First of all, we compared the intervention effects. In the study group, 43 cases were markedly effective, 5 cases were effective, 1 case was improved, 1 case was ineffective, and the effective rate was 98.00%. In the control group, 22 cases were markedly effective, 14 cases were effective, 7 cases were improved, 7 cases were ineffective, and the effective rate of 86.00%. The intervention effect of the study group was better compared to the control group (P < 0.05). Secondly, we compared the scores of the GMFM88 scale. The scores of D area and E area and total score of the study group were higher compared to the control group (P < 0.05). The IEMG values of gastrocnemius muscle and tibialis anterior muscle were compared, and the IMMG values of passive and active gastrocnemius muscle and tibialis anterior muscle in the study group were higher compared to the control group (P < 0.05). There exhibited no significant difference in CR value before intervention (P > 0.05). After intervention, the CR values of gastrocnemius muscle and tibialis anterior muscle in the study group were significantly lower compared to the control group (P < 0.05). In terms of the surface EMG of lower limbs, the EMG value of passive activity (gastrocnemius muscle, tibialis anterior muscle) in the study group was higher compared to the control group, and the EMG value of active activity was significantly lower compared to the control group (P < 0.05). Finally, we compared the compliance. In the study group, there were 43 cases of complete compliance, 7 cases of compliance, and 0 cases of noncompliance, with a compliance rate of 100.00%. In the control group, there were 32 cases of complete compliance, 11 cases of compliance, and 7 cases of noncompliance with a compliance rate of 86.00%. The compliance rate of the study group was better compared to the control group (P < 0.05). Conclusion The intervention of hospital-family rehabilitation model is helpful to improve the self-care ability, cognitive function, and daily activities of children with CP, enhance the walking function and lower limb surface electromyography of children with SCP, and strengthen their qualities of life.
Collapse
Affiliation(s)
- Jing Wang
- Department of Neurorehabilitation, Hebei Children's Hospital, China
| | - Ling Yue
- Department of Neurorehabilitation, Hebei Children's Hospital, China
| | - Zhihong Chen
- Nursing Department, Hebei Children's Hospital, China
| | - Bing Bai
- Department of Neurorehabilitation, Hebei Children's Hospital, China
| | - Cuiying Chen
- Department of Neurorehabilitation, Hebei Children's Hospital, China
| |
Collapse
|
9
|
Armani-Franceschi G, Luz C, Lucena PH, d'Afonseca D, Sales H, Carvalho AL, Siqueira IC, Silva K, Portuense S, Monteiro L, Bandeira ID, Melo A, Lucena R. Botulinum Toxin Type A in the Spasticity of Cerebral Palsy Related to Congenital Zika Syndrome: An Observational Study. Dev Neurorehabil 2022; 25:162-169. [PMID: 34387523 DOI: 10.1080/17518423.2021.1960917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
PURPOSE Investigate the effect of botulinum toxin type-A (BoNT-A) on spasticity and motor performance in children with Cerebral Palsy (CP) related to Congenital Zika Syndrome (CZS). METHODS Prospective longitudinal observational study of 34 children with CP referred for BoNT-A treatment. Outcomes were evaluated with a muscle tone assessment scale (Modified Ashworth Scale - MAS) and the Patients' Global Impression of Improvement (PGI-I) scale. RESULTS Mean age was 32.06 ± 3.07 months and 85% were classified as Gross Motor Function Classification System (GMFCS) V. Primitive reflexes were present in 56% of the sample. The majority of the parents (97.9%) reported improvement in range of motion or reduction in spasticity after treatment with botulinum toxin. No side effects were recorded. When compared to the baseline, median reduction in the MAS was 0.5 (IQR = 0). CONCLUSIONS The findings of this study suggest that BoNT-A may effectively promote functional improvements and reduce muscle tone, improving the child's and family's quality of life.
Collapse
Affiliation(s)
| | - Cleber Luz
- Universidade Federal da Bahia, Salvador, Brazil
| | - Pedro H Lucena
- Escola Bahiana de Medicina e Saúde Pública, Salvador, Brazil
| | | | | | | | | | | | | | | | | | - Ailton Melo
- Universidade Federal da Bahia, Salvador, Brazil
| | - Rita Lucena
- Universidade Federal da Bahia, Salvador, Brazil
| |
Collapse
|