Botulinum toxin type A injection increases range of motion in hip, knee and ankle joint contractures of children with cerebral palsy
Yıl: 2019 Cilt: 30 Sayı: 2 Sayfa Aralığı: 155 - 162 Metin Dili: İngilizce DOI: 10.5606/ehc.2019.65453 İndeks Tarihi: 25-11-2019
Botulinum toxin type A injection increases range of motion in hip, knee and ankle joint contractures of children with cerebral palsy
Öz: Objectives: This study aims to evaluate the clinical outcomes of children with spastic type cerebral palsy (CP) treated with botulinum toxin type A (BoNT-A) injection for lower limb contracture and the influence of age, gender, functional level and degree of initial contracture on treatment outcomes. Patients and methods: Clinical records at pre-BoNT-A injection and post-BoNT-A injections of 153 sessions of a total of 118 consecutive children (67 boys, 51 girls; mean age 5.9±2.6 years; range, 2.5-16 years) were retrospectively evaluated. Degrees of pre- and post-injection contracture were evaluated. Post-injection supplemental casting for 10 days was recorded in all cases. Less than 20° of hip flexion contracture, more than 30° of hip abduction, a negative prone Ely test, less than 50° of popliteal angle and at least 5° of ankle dorsiflexion values at post-injection were accepted as sufficient clinical improvement. Results: Sufficient post-injection range of motion (ROM) was observed in 80% of cases with hip flexion contracture, in 45% of cases with hip adduction contracture, in 84% of cases with knee flexion contracture and in 77% of cases with ankle equinus contracture. Prone Ely test that was positive in 60% of cases with knee extension contracture was negative at post-injection. Improvement in contractures were prominent in children with lesser degree initial contractures. Conclusion: Botulinum toxin type A injection increases ROM in hip, knee and ankle joint contractures in CP. Although age, gender and functional level may influence the clinical outcomes, pre-treatment level of contracture is the main determinant in improvement in ROM at post-injection.
Anahtar Kelime: Konular:
Botulinum toksin tip A enjeksiyonu serebral palsili çocukların kalça, diz ve ayak bileği eklemi kontraktürlerinde hareket açıklığını artırır
Öz: Amaç: Bu çalışmada alt ekstremite kontraktürü nedeniyle botulinum toksin tip A (BoNT-A) enjeksiyonu ile tedavi edilen spastik tip serebral palsi (SP)’li çocukların klinik sonuçları ve yaşın, cinsiyetin, fonksiyonel düzeyin ve başlangıç kontraktür derecesinin tedavi sonuçlarına etkisi değerlendirildi. Hastalar ve yöntemler: Toplam 118 ardışık çocuğun (67 erkek, 51 kız; ort. yaş 5.9±2.6 yıl; dağılım, 2.5-16 yıl) BoNT-A enjeksiyonu öncesi ve 153 seanslık BoNT-A enjeksiyonu sonrası klinik kayıtları retrospektif olarak değerlendirildi. Enjeksiyon öncesi ve sonrası kontraktür dereceleri değerlendirildi. Tüm olgularda enjeksiyon sonrası 10 günlük tamamlayıcı alçı uygulaması kayıt edildi. Enjeksiyon sonrası 20°’nin altında kalça fleksiyon kontraktürü, 30°’den fazla kalça abdüksiyonu, negatif pron Ely testi, 50°’nin altında popliteal açı ve en az 5° ayak bileği dorsifleksiyon değerleri yeterli klinik düzelme olarak kabul edildi. Bulgular: Kalça fleksiyon kontraktürü olan olguların %80’inde, kalça adduksiyon kontraktürü olan olguların %45’inde, diz fleksiyon kontraktürü olan olguların %84’ünde ve ayak bileği ekin kontraktürü olan olguların %77’sinde enjeksiyon sonrası yeterli eklem hareket açıklığı (EHA) görüldü. Diz ekstansiyon kontraktürü olan olguların %60’ında pozitif olan pron Ely testi enjeksiyon sonrası negatif idi. Başlangıç kontraktür düzeyi daha düşük olan çocuklarda kontraktürde iyileşme belirgin idi. Sonuç: Botulinum toksin tip A enjeksiyonu SP’de kalça, diz ve ayak bileği kontraktürlerinde EHA’yı artırır. Yaş, cinsiyet ve fonksiyonel düzey klinik sonuçları etkileyebilse de enjeksiyon sonrası EHA’daki iyileşme üzerinde temel belirleyici tedavi öncesi kontraktür derecesidir.
Anahtar Kelime: Konular:
Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
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| APA | aktas e, ÖMEROĞLU H (2019). Botulinum toxin type A injection increases range of motion in hip, knee and ankle joint contractures of children with cerebral palsy. , 155 - 162. 10.5606/ehc.2019.65453 |
| Chicago | aktas erdem,ÖMEROĞLU Hakan Botulinum toxin type A injection increases range of motion in hip, knee and ankle joint contractures of children with cerebral palsy. (2019): 155 - 162. 10.5606/ehc.2019.65453 |
| MLA | aktas erdem,ÖMEROĞLU Hakan Botulinum toxin type A injection increases range of motion in hip, knee and ankle joint contractures of children with cerebral palsy. , 2019, ss.155 - 162. 10.5606/ehc.2019.65453 |
| AMA | aktas e,ÖMEROĞLU H Botulinum toxin type A injection increases range of motion in hip, knee and ankle joint contractures of children with cerebral palsy. . 2019; 155 - 162. 10.5606/ehc.2019.65453 |
| Vancouver | aktas e,ÖMEROĞLU H Botulinum toxin type A injection increases range of motion in hip, knee and ankle joint contractures of children with cerebral palsy. . 2019; 155 - 162. 10.5606/ehc.2019.65453 |
| IEEE | aktas e,ÖMEROĞLU H "Botulinum toxin type A injection increases range of motion in hip, knee and ankle joint contractures of children with cerebral palsy." , ss.155 - 162, 2019. 10.5606/ehc.2019.65453 |
| ISNAD | aktas, erdem - ÖMEROĞLU, Hakan. "Botulinum toxin type A injection increases range of motion in hip, knee and ankle joint contractures of children with cerebral palsy". (2019), 155-162. https://doi.org/10.5606/ehc.2019.65453 |
| APA | aktas e, ÖMEROĞLU H (2019). Botulinum toxin type A injection increases range of motion in hip, knee and ankle joint contractures of children with cerebral palsy. Eklem Hastalıkları ve Cerrahisi Dergisi (Eski Adı: Artroplasti Artroskopik Cerrahi Derg.), 30(2), 155 - 162. 10.5606/ehc.2019.65453 |
| Chicago | aktas erdem,ÖMEROĞLU Hakan Botulinum toxin type A injection increases range of motion in hip, knee and ankle joint contractures of children with cerebral palsy. Eklem Hastalıkları ve Cerrahisi Dergisi (Eski Adı: Artroplasti Artroskopik Cerrahi Derg.) 30, no.2 (2019): 155 - 162. 10.5606/ehc.2019.65453 |
| MLA | aktas erdem,ÖMEROĞLU Hakan Botulinum toxin type A injection increases range of motion in hip, knee and ankle joint contractures of children with cerebral palsy. Eklem Hastalıkları ve Cerrahisi Dergisi (Eski Adı: Artroplasti Artroskopik Cerrahi Derg.), vol.30, no.2, 2019, ss.155 - 162. 10.5606/ehc.2019.65453 |
| AMA | aktas e,ÖMEROĞLU H Botulinum toxin type A injection increases range of motion in hip, knee and ankle joint contractures of children with cerebral palsy. Eklem Hastalıkları ve Cerrahisi Dergisi (Eski Adı: Artroplasti Artroskopik Cerrahi Derg.). 2019; 30(2): 155 - 162. 10.5606/ehc.2019.65453 |
| Vancouver | aktas e,ÖMEROĞLU H Botulinum toxin type A injection increases range of motion in hip, knee and ankle joint contractures of children with cerebral palsy. Eklem Hastalıkları ve Cerrahisi Dergisi (Eski Adı: Artroplasti Artroskopik Cerrahi Derg.). 2019; 30(2): 155 - 162. 10.5606/ehc.2019.65453 |
| IEEE | aktas e,ÖMEROĞLU H "Botulinum toxin type A injection increases range of motion in hip, knee and ankle joint contractures of children with cerebral palsy." Eklem Hastalıkları ve Cerrahisi Dergisi (Eski Adı: Artroplasti Artroskopik Cerrahi Derg.), 30, ss.155 - 162, 2019. 10.5606/ehc.2019.65453 |
| ISNAD | aktas, erdem - ÖMEROĞLU, Hakan. "Botulinum toxin type A injection increases range of motion in hip, knee and ankle joint contractures of children with cerebral palsy". Eklem Hastalıkları ve Cerrahisi Dergisi (Eski Adı: Artroplasti Artroskopik Cerrahi Derg.) 30/2 (2019), 155-162. https://doi.org/10.5606/ehc.2019.65453 |
