A randomized controlled trial comparing botulinum toxin A dosage in the upper extremity of children with spasticity

被引:47
作者
Kawamura, Anne
Campbell, Kent
Lam-Damji, Sophie
Fehlings, Darey
机构
[1] Univ Toronto, Bloorview Res Inst, Bloorview Kids Rehab, Dept Paediat, Toronto, ON M4G 1R8, Canada
[2] Univ Toronto, Dept Publ Hlth Sci, Toronto, ON M4G 1R8, Canada
[3] Univ Toronto, Dept Occupat Sci & Occupat Therapy, Toronto, ON M4G 1R8, Canada
关键词
UPPER-LIMB SPASTICITY; CEREBRAL-PALSY; INJECTIONS; RELIABILITY;
D O I
10.1111/j.1469-8749.2007.00331.x
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
This study compared the effects of low and high doses of botulinum toxin A (BTX-A) to improve upper extremity function. Thirty-nine children (22 males, 17 females) with a mean age of 6 years 2 months (SD 2y 9mo) diagnosed with spastic hemiplegia or triplegia were enrolled into this double-blind, randomized controlled trial. The high-dose group received BTX-A in the following doses: biceps 2U/kg, brachioradialis 1.5U/kg, common flexor origin 3U/kg, pronator teres 1.5U/kg, and adductor/opponens pollicis 0.6U/kg to a maximum of 20U. The low-dose group received 50% of this dosage. Outcomes were measured at baseline and at 1 and 3 months after injection, and results were analyzed with a repeated-measures analysis of variance. There was no significant difference between the low-dose and high-dose groups in upper extremity function over the 3-month period as measured by the Quality of Upper Extremity Skills Test (F[1,37]=0.18,p=0.68). There was no difference between the groups in the Pediatric Evaluation of Disability Inventory Self Care Domain (F[1,37]=0.05,p=0.83). Although grip strength decreased over the 3-month period, there was no difference between groups (F[1,32]=0.45,p=0.51). These findings indicate that there is no difference in hand and arm function between a low dose and a high dose of BTX-A at 1 and 3 months after injection. This information can be used to guide dosage of BTX-A for the management of upper extremity spasticity in children.
引用
收藏
页码:331 / 337
页数:7
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