BACKGROUND: Children with spastic hemiparesis frequently present with impaired hand function due to paresis, spasticity, and disturbed motor control. The aim of this study was to examine the effectiveness of functional electrical stimulation in combination with botulinum toxin type A in these children. DESIGN: Randomized, controlled, observer-blinded pilot study. SUBJECTS:Children with impaired hand function. INTERVENTIONS: Either a combined treatment group (functional electrical stimulation and botulinum toxin type A) or a botulinum toxin type A group alone. Botulinum toxin type A was injected into arm muscles according to the patient's clinical requirements. Functional electrical stimulation of the wrist and finger extensor muscles was started after five to six days. Patients were given a stimulation device and asked to use it at home twice daily for 15 min, for a total period of three months. MAIN MEASURES: Active and passive range of motion, muscle tone, muscle strength, and functional tests for children. RESULTS:Six children aged between 7 and 17 years with spastic hemiparesis were enrolled. In both groups, active and passive range of motion, muscle tone, and muscle strength improved after three and six months compared to baseline data. The functional score was improved only in the group that received combined treatment. CONCLUSIONS: Combined treatment with functional electrical stimulation and botulinum toxin type A is a promising treatment option to improve upper limb function in children with spastic hemiparesis.
RCT Entities:
BACKGROUND:Children with spastic hemiparesis frequently present with impaired hand function due to paresis, spasticity, and disturbed motor control. The aim of this study was to examine the effectiveness of functional electrical stimulation in combination with botulinum toxin type A in these children. DESIGN: Randomized, controlled, observer-blinded pilot study. SUBJECTS:Children with impaired hand function. INTERVENTIONS: Either a combined treatment group (functional electrical stimulation and botulinum toxin type A) or a botulinum toxin type A group alone. Botulinum toxin type A was injected into arm muscles according to the patient's clinical requirements. Functional electrical stimulation of the wrist and finger extensor muscles was started after five to six days. Patients were given a stimulation device and asked to use it at home twice daily for 15 min, for a total period of three months. MAIN MEASURES: Active and passive range of motion, muscle tone, muscle strength, and functional tests for children. RESULTS: Six children aged between 7 and 17 years with spastic hemiparesis were enrolled. In both groups, active and passive range of motion, muscle tone, and muscle strength improved after three and six months compared to baseline data. The functional score was improved only in the group that received combined treatment. CONCLUSIONS: Combined treatment with functional electrical stimulation and botulinum toxin type A is a promising treatment option to improve upper limb function in children with spastic hemiparesis.
Authors: A M Bakheit; A F Thilmann; A B Ward; W Poewe; J Wissel; J Muller; R Benecke; C Collin; F Muller; C D Ward; C Neumann Journal: Stroke Date: 2000-10 Impact factor: 7.914