Department of Physical and Rehabilitation Medicine, Sungkyunkwan University School of Medicine, Ilwon-dong, Kangnam-gu, Seoul, Republic of Korea.
Am J Phys Med Rehabil. 2010 Apr;89(4):279-86. doi: 10.1097/PHM.0b013e3181ca24ac.
To compare the clinical outcomes of two different injection techniques, one guided by electric stimulation and the other by sonography, for botulinum toxin A injection into calf muscles for the treatment of spastic equinus in children with cerebral palsy.
Thirty-two children with cerebral palsy with spastic equinus gait were enrolled in separate categories according to their level under the Gross Motor Function Classification System and divided into two groups with alternate allocation: sonography-guided group and electric stimulation-guided group. Equal amounts of botulinum toxin A were injected into the gastrocnemius at four to six points in 30 children with cerebral palsy. The injection was guided by electric stimulation in 14 and by ultrasonography in 16 children. Modified Ashworth Scale, Modified Tardieu Scale, Selective Motor Control, and Physician's Rating Scale were measured at baseline, 1 mo, and 3 mos posttreatment.
Subscales of the Physician's Rating Scale (gait pattern and hindfoot position-maximum foot/floor contact during stance) significantly improved in the sonography-guided group. No statistical differences were noted in Modified Ashworth Scale, Modified Tardieu Scale, and Selective Motor Control.
Visual feedback by ultrasonography could improve the accuracy of selective neuromuscular blocking of the gastrocnemius.
比较两种不同注射技术的临床疗效，一种是电刺激引导，另一种是超声引导，用于治疗脑瘫患儿痉挛性马蹄内翻足的 A 型肉毒毒素注射。
根据粗大运动功能分类系统，32 名痉挛性马蹄内翻足步态的脑瘫患儿被分为两组，采用交替分配法，分为超声引导组和电刺激引导组。在 30 名脑瘫患儿的腓肠肌的四个或六个点注射等量的肉毒毒素 A，其中 14 名患儿接受电刺激引导注射，16 名患儿接受超声引导注射。在基线、1 个月和 3 个月治疗后，采用改良 Ashworth 量表、改良 Tardieu 量表、选择性运动控制和医生评定量表进行测量。
在超声引导组，医生评定量表的子量表（步态模式和后足位置-站立时最大足/地面接触）显著改善。改良 Ashworth 量表、改良 Tardieu 量表和选择性运动控制均无统计学差异。
超声的视觉反馈可提高腓肠肌选择性神经肌肉阻滞的准确性。
