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- Title
Botulinum neurotoxin treatment in children with cerebral palsy: validation of a needle placement protocol using passive muscle stretching and relaxing.
- Authors
Warnink‐Kavelaars, Jessica; Vermeulen, R Jeroen; Buizer, Annemieke I; Becher, Jules G
- Abstract
<bold>Aim: </bold>To validate a detailed intramuscular needle placement protocol using passive muscle stretching and relaxing for botulinum neurotoxin type A (BoNT-A) treatment in the lower extremity of children with spastic cerebral palsy (CP), with verification by electrical stimulation.<bold>Method: </bold>A prospective observational study was performed in 75 children with spastic CP who received regular BoNT-A treatment under general anaesthesia (52 males, 23 females; mean age 8y 9mo, SD 3y 7mo, range 4-18y; mean body mass index 16.2, SD 3.7, range 7.7-26.7). A total of 1084 intramuscular needle placements using passive muscle stretching and relaxing were verified by electrical stimulation. Primary outcome was the positive predictive value.<bold>Results: </bold>Intramuscular needle placement in the muscles adductor brevis, adductor longus, gracilis, semimembranosus, semitendinosus, biceps femoris, rectus femoris, and lateral and medial heads of the gastrocnemius and soleus had a positive predictive value ranging from 85.7% to 100% (95% confidence interval ranging from 71.5-89.9% to 91.4-100%).<bold>Interpretation: </bold>This validated detailed protocol for intramuscular needle placement using passive muscle stretching and relaxing for BoNT-A treatment in the lower extremity of children with spastic CP is reliable and has a high positive predictive value.
- Subjects
CEREBRAL palsy treatment; BOTULINUM toxin; THERAPEUTICS; CHILDREN with cerebral palsy; TREATMENT effectiveness; ELECTRIC stimulation; MEDICAL protocols; CEREBRAL palsy; COMPARATIVE studies; INJECTIONS; INTRAMUSCULAR injections; RESEARCH methodology; MEDICAL cooperation; MUSCLE relaxants; RESEARCH; EVALUATION research; SKELETAL muscle
- Publication
Developmental Medicine & Child Neurology, 2016, Vol 58, Issue 12, p1281
- ISSN
0012-1622
- Publication type
journal article
- DOI
10.1111/dmcn.13176