Use of three-dimensional kinematic analysis following upper limb botulinum toxin A for children with hemiplegia
Article first published online: 22 AUG 2008
© 2008 The Author(s). Journal compilation © 2008 EFNS
European Journal of Neurology
Volume 15, Issue 11, pages 1191–1198, November 2008
How to Cite
Mackey, A. H., Miller, F., Walt, S. E., Waugh, M.-C. and Stott, N. S. (2008), Use of three-dimensional kinematic analysis following upper limb botulinum toxin A for children with hemiplegia. European Journal of Neurology, 15: 1191–1198. doi: 10.1111/j.1468-1331.2008.02271.x
- Issue published online: 6 OCT 2008
- Article first published online: 22 AUG 2008
- Received 29 April 2008 Accepted 1 July 2008
- cerebral palsy;
- upper extremity
Background and purpose: To examine whether three-dimensional (3-D) kinematic analysis can detect changes in upper limb tasks (reach and hand-to-mouth) in children with hemiplegia, following upper limb botulinum toxin A injections.
Methods: Ten children with hemiplegic cerebral palsy (7 males, 3 females, aged 9–17 years). Subjects received botulinum toxin A (Botox) injections into elbow forearm muscles combined with 6 weeks of occupational therapy. Participants completed a 3-D kinematic analysis of two upper limb tasks, Melbourne Assessment of Unilateral Upper Limb Function and modified Ashworth scores measured at baseline, 2, 6 and 12 weeks post-injection.
Results: Post-injections, elbow flexor muscle tone was reduced for 12 weeks (p < 0.05). Group differences in active range of motion during 3-D analysis tasks could not be demonstrated at any time post-intervention. However, individual analyses found that at 2 weeks post-injection, three subjects had >15 degrees increases in active elbow extension and six subjects showed an increase of >25 degrees in forearm supination during performance of the reach and hand-to-mouth tasks, respectively.
Conclusions: 3-D kinematics can detect changes in active movements during functional tasks following botulinum toxin A injections, suggesting this could be a potential objective outcome measure in a clinical trial.