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| [PMID]: | 27631386 |
| [Au] Autor: | Dursun N; Gokbel T; Akarsu M; Dursun E |
| [Ad] Endereço: | From the Department of Physical Medicine and Rehabilitation, Kocaeli University, Kocaeli, Turkey. |
| [Ti] Título: | Randomized Controlled Trial on Effectiveness of Intermittent Serial Casting on Spastic Equinus Foot in Children with Cerebral Palsy After Botulinum Toxin-A Treatment. |
| [So] Source: | Am J Phys Med Rehabil;96(4):221-225, 2017 Apr. | | [Is] ISSN: | 1537-7385 |
| [Cp] País de publicação: | United States |
| [La] Idioma: | eng |
| [Ab] Resumo: | OBJECTIVE: Physical therapy (PT) and botulinum toxin-A (BTX-A) injections are widely used in the treatment of spastic equinus foot due to cerebral palsy. The aim of this study was to show effects of intermittent serial casting (SC) in addition to standard treatment on spasticity, passive range of motion (PROM), and gait. DESIGN: Fifty-one ambulatory patients, treated by BTX-A to plantar flexor muscles, were randomly assigned to casting or control groups in a 2:1 ratio. Both groups received PT for 3 weeks. Casting group additionally received intermittent SC during 3 consecutive weekends. Assessments included Modified Ashworth Scale (MAS), Tardieu Scale, Observational Gait Scale (OGS), and Physician Global Assessment at baseline and posttreatment weeks 4 and 12. RESULTS: Significant improvements in PROM, MAS, Tardieu Scale, and OGS were recorded in both groups (P < 0.001 for all). Average changes in MAS, PROM, angle of catch, spasticity angle, and OGS of the casting group were significantly higher than those of the controls at week 4 (P = 0.006, P = 0.002, P < 0.001, P = 0.005, P = 0.011), and 12 (P = 0.013, P < 0.001, P < 0.001, P = 0.011, P < 0.001). Follow-up Physician Global Assessment also favored casting group (P < 0.001 for both). CONCLUSIONS: Combining intermittent SC with BTX-A injections and PT might provide additional benefits for spastic equinus foot. TO CLAIM CME CREDITS: Complete the self-assessment activity and evaluation online at http://www.physiatry.org/JournalCME CME OBJECTIVES: Upon completion of this article, the reader should be able to: (1) identify treatment options for spastic equinus goot in children with cerebral palsy; (2) explain different approaches of serial casting with an additional model of intermittent casting; and (3) describe the potential benefits of combined treatment modalities, including intermittent serial casting, for spastic equinus foot in children with cerebral palsy. LEVEL: Advanced ACCREDITATION: The Association of Academic Physiatrists is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.The Association of Academic Physiatrists designates this activity for a maximum of 1.5 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity. |
| [Mh] Termos MeSH primário: |
Toxinas Botulínicas Tipo A/uso terapêutico
Moldes Cirúrgicos
Paralisia Cerebral/reabilitação
Pé Equino/reabilitação
Fármacos Neuromusculares/uso terapêutico
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| [Mh] Termos MeSH secundário: |
Paralisia Cerebral/fisiopatologia
Criança
Terapia Combinada
Pé Equino/fisiopatologia
Feminino
Seres Humanos
Masculino
Modalidades de Fisioterapia
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| [Pt] Tipo de publicação: | JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL |
[Nm] Nome de substância:
| 0 (Neuromuscular Agents); EC 3.4.24.69 (Botulinum Toxins, Type A) |
| [Em] Mês de entrada: | 1708 |
| [Cu] Atualização por classe: | 170807 |
[Lr] Data última revisão:
| 170807 |
| [Sb] Subgrupo de revista: | AIM; IM |
| [Da] Data de entrada para processamento: | 160916 |
| [St] Status: | MEDLINE |
| [do] DOI: | 10.1097/PHM.0000000000000627 |
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