Evaluation of group versus individual physiotherapy following lower limb intra-muscular Botulinum Toxin-Type A injections for ambulant children with cerebral palsy: a single-blind randomized comparison trial

Thomas, Rachel E., Johnston, Leanne M., Sakzewski, Leanne, Kentish, Megan J. and Boyd, Roslyn N. (2016) Evaluation of group versus individual physiotherapy following lower limb intra-muscular Botulinum Toxin-Type A injections for ambulant children with cerebral palsy: a single-blind randomized comparison trial. Research in Developmental Disabilities, 53-54 267-278. doi:10.1016/j.ridd.2016.02.014


Author Thomas, Rachel E.
Johnston, Leanne M.
Sakzewski, Leanne
Kentish, Megan J.
Boyd, Roslyn N.
Title Evaluation of group versus individual physiotherapy following lower limb intra-muscular Botulinum Toxin-Type A injections for ambulant children with cerebral palsy: a single-blind randomized comparison trial
Journal name Research in Developmental Disabilities   Check publisher's open access policy
ISSN 1873-3379
0891-4222
Publication date 2016-06-01
Sub-type Article (original research)
DOI 10.1016/j.ridd.2016.02.014
Open Access Status Not Open Access
Volume 53-54
Start page 267
End page 278
Total pages 12
Place of publication Kidlington, Oxford, United Kingdom
Publisher Elsevier
Collection year 2017
Language eng
Formatted abstract
This study aimed to evaluate efficacy of group (GRP) versus individual (IND) physiotherapy rehabilitation following lower limb intramuscular injections of Botulinum Toxin-Type A (BoNT-A) for ambulant children with cerebral palsy (CP). Following lower limb BoNT-A injections, 34 children were randomly allocated to GRP (n = 17; mean age 7y8m SD 2.0; 13 males; Gross Motor Function Classification System (GMFCS) I = 5, II = 8, III = 4) or IND physiotherapy (n = 17; mean age 8y7m SD 2.0; 11 males; GMFCS I = 9, II = 5, III = 3). Primary outcomes were the Canadian Occupational Performance Measure (COPM) and Edinburgh Visual Gait Score (EVGS) assessed at baseline, 10 and 26 weeks post intervention. There were no baseline differences between groups. GRP intervention had greater, but not clinically meaningful, improvement in COPM satisfaction (estimated mean difference EMD 1.7, 95% CI 0.4-3.1; p < 0.01) at 26 weeks. Both groups demonstrated clinically significant improvements in COPM performance and satisfaction, but minimal change in quality of gait (EVGS). Six hours of direct physiotherapy (either GRP or IND) with an additional indirect dose (median 16 episodes) of individualized home programme activities following lower limb BoNT-A injections, however, was inadequate to drive clinically meaningful changes in lower limb motor outcomes.
Keyword Botulinum Toxin-A
Cerebral palsy
Lower limb
Model of care
Physiotherapy
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

 
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