ARTICLE LINKS: BOTULINUM TOXIN TYPE A INJECTIONS INTO THE CALF MUSCLES FOR TREATMENT OF SPASTIC EQUINUS IN CEREBRAL PALSY: A RANDOMIZED TRIALPARING SINGLE AND MULTIPLE INJECTION SITES.ORIGINAL RESEARCH ARTICLE American Journal of Physical Medicine Pietikainen, Tarja PT; Iisalo, Terhi PT; Lehtonen-Raty, Pirjo PT; Salo, Marja PT; Haataja, Riina MSc; Koivikko, Matti PhD; Autti-Ramo, Ilona PhD _ ABSTRACT: Satila H, Pietikainen T, Iisalo T, Lehtonen-Raty P, Salo M, Haataja R, Koivikko M, Autti-Ramo I: Botulinum toxin type a injections into the calf muscles for treatment of spastic equinus in cerebral palsy: a randomized trialparing single and multiple injection sites.Phys Med Rehabil 2008;87:386-394.Investigate the hypothesis that the multiple-site injection technique is associated with better oues than the single-point injection method in children with cerebral palsy and spastic equinus gait.Total of 17 children (nine boys, eight girls ages 1.Yrs; eight hemiplegics, eight diplegics, one quadriplegic; levels I-IV with the Gross Motor Function Classification System) with 25 treated lower limbs were randomized into two groups: a single-point group receiving a standard dose of botulinum toxin A injection into one site and a multiple-points group into two sites on both heads of the gastrocnemius.And passive range of movement, selective dorsiflexion, dynamic muscle length (modified Tardieu scale), calf tone (modified Ashworth scale), attainment of anticipated gait pattern (Goal Attainment Scale), and video gait analysis (Observational Gait Scale ) were assessed before and 1, 2, and 4 mos after intervention.Groups improved in dynamic muscle length, muscle tone, OGS-total scores and initial foot contact scores and a similar number of children attained their goals on the Goal Attainment Scale.Only significant difference between the groups was observed at 2 mos in passive dorsiflexion with the knee flexed, favoring the single-point group.Not significantly, the incidence of adverse effects was higher in the multiple-points group.The methods described, no major changes in main oue measures were associated with the number of injection sites.Than efficacy guide the decision on whether to inject in single or multiple sites when treating spastic equinus with botulinum toxin.Lippincott Williams & Wilkins, Inc.2008, Association of Academic Physiatrists.Rights reserved.By Lippincott Williams & Wilkins.Read more An important message to anyone taking viagra… from the women who love you
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