Ultrasound-guided botulinum toxin type A injection to the iliopsoas muscle in the management of children with cerebral palsy

Objective: To determine the effect of botulinum toxin type A (BTX-A) on spasticity and functional development in children with cerebral palsy (CP) in conjunction with a physiotherapy program. Method: In this prospective study, 18 CP patients were evaluated. Multilevel BTX-A injection was applied to children at a dose of 15 U/kg. Children were assessed before and at the 5th and 12th week post-injection using Thomas test, Duncan-Ely test, passive range of motion (pROM) measurement, Distance Between Knee (DBK), Selective Motor Control (SMC) scale, modified Ashworth Scale (MAS) and modified Physician Rating Scale (mPRS). To assess functional improvement, Gross Motor Function Measure (GMFM) and Functional Independence Measure for Children (WeeFIM) were used before and at the 12th week post-injection. Results: At 5th week post-injection, a statistically significant decrease was determined in spasticity (p < 0.01). Improvement was observed in mPRS and pROM, but not in SMC. At the 12th week post-injection, GMFM (p < 0.001) and WeeFIM improved significantly (p < 0.001). The improvement in pROM and mPRS (p < 0.01) lasted until the 12th week post-injection, but the improvement in MAS (p > 0.05) and in the Tardieu test of hip adductors (p > 0.05) did not last after the 5th week. Conclusion: BTX-A injection enhances functional and motor abilities in the development process.