Park Eun Sook, Sim Eungeol, Rha Dong-Wook, Jung Soojin
Department of Rehabilitation Medicine, Severance Hospital, Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul, Korea.
Yonsei Med J. 2014 Sep;55(5):1406-12. doi: 10.3349/ymj.2014.55.5.1406.
This study used ultrasonography (US) to investigate the architectural changes in gastrocnemius muscles (GCM) after botulinum toxin injection (BoNT-A) in children with cerebral palsy (CP).
Thirteen children with CP who received a BoNT-A injection into their GCM to treat equinus were recruited (9 males and 4 females). Architectural changes in both the medial and lateral heads of the GCM from a total of 20 legs were assessed using B-mode, real-time US. Muscle thickness (MT), fascicle length (FL), and fascicle angle (FA) were measured over the middle of the muscle belly in both a resting and neutral ankle position. Measures at 1 and 3 months after the injection were compared with baseline data taken before the injection.
The mean age of the subjects was 5.8 (±1.6) years. Spasticity was significantly reduced when measured by both the modified Tardieu scale and the modified Ashworth scale at 1 and 3 months after injection (p<0.05). The MT and FA of both the medial and lateral heads of the GCM were significantly reduced for both neutral and resting ankle positions at 1 and 3 months after the injection. The FL of both the medial and lateral heads of the GCM were significantly increased in a resting position (p<0.05), but not in a neutral position.
Our results demonstrated muscle architectural changes induced by BoNT-A injection. The functional significances of these changes were discussed.
本研究采用超声检查（US）来探究肉毒毒素A（BoNT-A）注射对脑瘫（CP）患儿腓肠肌（GCM）结构变化的影响。
招募了13名接受BoNT-A注射到其GCM以治疗马蹄足的CP患儿（9名男性和4名女性）。使用B型实时US评估了总共20条腿的GCM内侧头和外侧头的结构变化。在踝关节休息和中立位时，在肌腹中部测量肌肉厚度（MT）、肌束长度（FL）和肌束角度（FA）。将注射后1个月和3个月时的测量结果与注射前获取的基线数据进行比较。
受试者的平均年龄为5.8（±1.6）岁。注射后1个月和3个月时，通过改良Tardieu量表和改良Ashworth量表测量，痉挛程度均显著降低（p<0.05）。注射后1个月和3个月时，在踝关节中立位和休息位，GCM内侧头和外侧头的MT和FA均显著降低。GCM内侧头和外侧头的FL在休息位时显著增加（p<0.05），但在中立位时未增加。
我们的结果表明了BoNT-A注射引起的肌肉结构变化。讨论了这些变化的功能意义。
Zotero 插件