Alessandro Picelli1, Elisabetta La Marchina1, Francesca Gajofatto2, Angelo Pontillo1, Antonella Vangelista2, Roberto Filippini2, Alessio Baricich3,4, Carlo Cisari3,4, Nicola Smania1,5. 1. a Neuromotor and Cognitive Rehabilitation Research Centre, Department of Neurological , Biomedical and Movement Sciences, University of Verona , Verona , Italy. 2. b Polyfunctional Centre "Don Calabria" , Verona , Italy. 3. c Physical and Rehabilitative Medicine , University Hospital "Maggiore della Carità" , Novara , Italy. 4. d Department of Health Sciences , Piemonte Orientale University , Novara , Italy. 5. e Neurorehabilitation Unit , Hospital Trust of Verona , Verona , Italy.
Abstract
OBJECTIVE: The aim of this study was to compare the combined sonographic and clinical effects of botulinum toxin type A (BoNT-A) and extracorporeal shock wave therapy (ESWT) versus BoNT-A alone in children with cerebral palsy. METHODS:Ten children with spastic cerebral palsy were randomly assigned to one of two groups. Group 1 received BoNT-A injection into the spastic muscles of the affected limbs plus three ESWT sessions. Group 2 received BoNT-A alone. Assessment was performed before and 1 month after injection. Sonographic outcomes were injected muscles echo intensity and their hardness percentage, and clinical outcomes the modified Ashworth scale and the Tardieu scale. RESULTS: At 1-month evaluation, significant differences in the injected muscles percentage of hardness (P = 0.021) and the modified Ashworth scale (P = 0.001) were found between groups. CONCLUSIONS: Our results support the hypothesis that the combined effects of BoNT-A and ESWT derive from their respective action on neurological and non-neural rheological components in spastic muscles.
RCT Entities:
OBJECTIVE: The aim of this study was to compare the combined sonographic and clinical effects of botulinum toxin type A (BoNT-A) and extracorporeal shock wave therapy (ESWT) versus BoNT-A alone in children with cerebral palsy. METHODS: Ten children with spastic cerebral palsy were randomly assigned to one of two groups. Group 1 received BoNT-A injection into the spastic muscles of the affected limbs plus three ESWT sessions. Group 2 received BoNT-A alone. Assessment was performed before and 1 month after injection. Sonographic outcomes were injected muscles echo intensity and their hardness percentage, and clinical outcomes the modified Ashworth scale and the Tardieu scale. RESULTS: At 1-month evaluation, significant differences in the injected muscles percentage of hardness (P = 0.021) and the modified Ashworth scale (P = 0.001) were found between groups. CONCLUSIONS: Our results support the hypothesis that the combined effects of BoNT-A and ESWT derive from their respective action on neurological and non-neural rheological components in spastic muscles.
Authors: A Picelli; S Tamburin; G Berto; E Chemello; Marialuisa Gandolfi; Leopold Saltuari; Andreas Waldner; Nicola Smania Journal: Funct Neurol Date: 2017 Jul/Sep