Wallen Margaret, O'Flaherty Stephen J, Waugh Mary-Clare A
Department of Occupational Therapy, The Children's Hospital at Westmead, Sydney, Australia.
Arch Phys Med Rehabil. 2007 Jan;88(1):1-10. doi: 10.1016/j.apmr.2006.10.017.
To investigate the functional outcomes of botulinum toxin type A (BTX-A) injections to the upper limb in combination with occupational therapy (OT) in children with cerebral palsy (CP).
Randomized controlled trial with follow-up at 2 weeks, 3 months, and 6 months.
Specialist outpatient physical disabilities clinic within a public pediatric teaching hospital.
Eighty children with spastic quadriplegic, triplegic, or hemiplegic CP from these clinics were randomly assigned to BTX-A plus OT, BTX-A alone, OT alone, or a no-treatment control group.
Single set of BTX-A (Botox) injections and 12 weeks of OT.
Canadian Occupational Performance Measure (COPM) and Goal Attainment Scale (GAS).
The combination of BTX-A and OT resulted in accelerated attainment of functional goals measured by the COPM and GAS. There were no differences between groups on the Melbourne Assessment of Unilateral Upper Limb Function, Quality of Upper Extremity Skills Test, Pediatric Evaluation of Disability Inventory, Child Health Questionnaire, or active and passive range of motion. As expected, there was a significant reduction in muscle tone at follow-up 2 weeks after injection, which returned to baseline level by 6 months.
OT enhanced individualized functional outcomes following BTX-A injections in the upper limbs of children with CP.
探讨A型肉毒毒素（BTX-A）注射上肢联合职业治疗（OT）对脑瘫（CP）患儿功能结局的影响。
随机对照试验，随访2周、3个月和6个月。
一家公立儿科教学医院的专科门诊肢体残疾诊所。
从这些诊所招募的80名痉挛性四肢瘫、三肢瘫或偏瘫型CP患儿被随机分配至BTX-A联合OT组、单纯BTX-A组、单纯OT组或无治疗对照组。
单次注射BTX-A（保妥适）并进行12周的OT。
加拿大职业表现测量量表（COPM）和目标达成量表（GAS）。
BTX-A与OT联合应用使通过COPM和GAS测量的功能目标达成加速。在墨尔本单侧上肢功能评估、上肢技能质量测试、儿童残疾评估量表、儿童健康问卷或主动和被动活动范围方面，各组之间无差异。正如预期的那样，注射后2周随访时肌张力显著降低，到6个月时恢复至基线水平。
OT可改善CP患儿上肢注射BTX-A后的个体化功能结局。
