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Botulinum toxin type A or selective neurotomy for treating focal spastic muscle overactivity? / Thierry Deltombe in Annals of physical and rehabilitation medicine, Vol. 62, n°4 (Juillet 2019)
[article]
Titre : Botulinum toxin type A or selective neurotomy for treating focal spastic muscle overactivity? Type de document : texte imprimé Auteurs : Thierry Deltombe ; Thierry Lejeune ; Thierry Gustin Année de publication : 2019 Article en page(s) : p. 220-224 Note générale : https://doi.org/10.1016/j.rehab.2018.07.008 Langues : Anglais (eng) Mots-clés : Hemiplegia Muscle spasticity Motor nerve block Neurotomy Equinovarus foot Résumé : Objective
To discuss the effectiveness, indications, limitations and side effects of botulinum toxin type A and selective neurotomy for treating focal spastic muscle overactivity to help clinicians choose the most appropriate treatment.
Methods
Expert opinion based on scientific evidence and personal experience.
Results
Botulinum toxin type A can decrease muscle tone in different types of spastic muscle overactivity, which allows for treating a large variety of spastic patterns with several etiologies. The toxin effect is sometimes insufficient to improve functional outcome and is transient, thereby requiring repeated injections. Selective neurotomy is a permanent surgical treatment of the reflex component of the spastic muscle overactivity (spasticity) that is effective for spastic equinovarus foot. The neurotomy provides a greater and more constant reduction in spasticity. However, the long-lasting effect on the non-reflex muscle overactivity, especially dystonia, is doubted. The effectiveness, clinical indications, advantages, side effects and limitations of both techniques are discussed.
Conclusion
Botulinum toxin type A has the highest level of evidence and the largest range of indications. However, the botulinum toxin effect is reversible and seems less effective, which supports a permanent surgical treatment such as selective neurotomy, especially for the spastic foot. Further research is needed to compare the effect of botulinum toxin type A and selective neurotomy for the different types of spastic muscle overactivity and clinical patterns.En ligne : https://www.sciencedirect.com/science/article/pii/S1877065718314398 Permalink : ./index.php?lvl=notice_display&id=84126
in Annals of physical and rehabilitation medicine > Vol. 62, n°4 (Juillet 2019) . - p. 220-224[article] Botulinum toxin type A or selective neurotomy for treating focal spastic muscle overactivity? [texte imprimé] / Thierry Deltombe ; Thierry Lejeune ; Thierry Gustin . - 2019 . - p. 220-224.
https://doi.org/10.1016/j.rehab.2018.07.008
Langues : Anglais (eng)
in Annals of physical and rehabilitation medicine > Vol. 62, n°4 (Juillet 2019) . - p. 220-224
Mots-clés : Hemiplegia Muscle spasticity Motor nerve block Neurotomy Equinovarus foot Résumé : Objective
To discuss the effectiveness, indications, limitations and side effects of botulinum toxin type A and selective neurotomy for treating focal spastic muscle overactivity to help clinicians choose the most appropriate treatment.
Methods
Expert opinion based on scientific evidence and personal experience.
Results
Botulinum toxin type A can decrease muscle tone in different types of spastic muscle overactivity, which allows for treating a large variety of spastic patterns with several etiologies. The toxin effect is sometimes insufficient to improve functional outcome and is transient, thereby requiring repeated injections. Selective neurotomy is a permanent surgical treatment of the reflex component of the spastic muscle overactivity (spasticity) that is effective for spastic equinovarus foot. The neurotomy provides a greater and more constant reduction in spasticity. However, the long-lasting effect on the non-reflex muscle overactivity, especially dystonia, is doubted. The effectiveness, clinical indications, advantages, side effects and limitations of both techniques are discussed.
Conclusion
Botulinum toxin type A has the highest level of evidence and the largest range of indications. However, the botulinum toxin effect is reversible and seems less effective, which supports a permanent surgical treatment such as selective neurotomy, especially for the spastic foot. Further research is needed to compare the effect of botulinum toxin type A and selective neurotomy for the different types of spastic muscle overactivity and clinical patterns.En ligne : https://www.sciencedirect.com/science/article/pii/S1877065718314398 Permalink : ./index.php?lvl=notice_display&id=84126 Exemplaires (1)
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Exclu du prêtHand and Arm Bimanual Intensive Therapy Including Lower Extremity (HABIT-ILE) in Children With Unilateral Spastic Cerebral Palsy : A Randomized Trial / Yannick Bleyenheuft
Titre : Hand and Arm Bimanual Intensive Therapy Including Lower Extremity (HABIT-ILE) in Children With Unilateral Spastic Cerebral Palsy : A Randomized Trial Type de document : document électronique Auteurs : Yannick Bleyenheuft ; Carlyne Arnould ; Marina B. Brandao ; Corrine Bleyenheuft ; Andrew M. Gordon Année de publication : 2014 Note générale : Cet article est paru dans le revue Neurorehabilitation and Neural Repair sous le doi: 10.1177/1545968314562109 Langues : Anglais (eng) Mots-clés : upper extremity rehabilitation lower extremity rehabilitation cerebral palsy bimanual training hand, posture motor skill learning intensive training eurorehabilitation gait dose hemiplegia children Résumé : Background. Intensive bimanual training results in more improvement in hand function in children with unilateral spastic cerebral palsy (USCP) than lower intensity conventional interventions. However, it is not known whether combined upper and lower extremity training in an intensive protocol is more efficacious for upper and lower functional abilities than conventional therapies provided in usual customary care. Objective. To determine the efficacy of Hand and Arm Bimanual Intensive Therapy Including Lower Extremity (HABIT-ILE) for children with USCP. Methods. Twenty-four children with USCP were randomized into 2 groups: an immediate HABIT-ILE group (IHG, initially receiving HABIT-ILE, 10 days = 90 hours), and a delayed HABIT-ILE group (DHG), which continued their conventional/ongoing treatment for an intended total duration of 90 hours. In phase 2, children in the DHG were crossed over to receive HABIT-ILE and children of the IHG were followed in their ongoing conventional therapy. Children were assessed using the Assisting Hand Assessment (AHA, primary outcome), the ABILHAND-Kids, and the Pediatric Evaluation of Disability Inventory. Dexterity (Box and Blocks Test [BBT]) and pinch strength were also measured. Locomotor abilities were assessed with Six-Minute Walk Test (6MWT, primary outcome) and ABILOCO-kids. Social participation was measured with the Assessment of Life-HABITs. Results. A 2 (groups) × 3 (test sessions) analysis of variance indicated significant improvements for primary outcomes (AHA, P < .001; 6MWT, P = .002) and all secondary assessments except BBT, step length and bodyweight distribution following HABIT-ILE, but not conventional therapy. Conclusion. The findings suggest that combined upper and lower extremity in an intensive training protocol may be efficacious for improving both upper and lower extremity function in children with USCP. En ligne : https://journals.sagepub.com/doi/pdf/10.1177/1545968314562109 Permalink : ./index.php?lvl=notice_display&id=98143 Hand and Arm Bimanual Intensive Therapy Including Lower Extremity (HABIT-ILE) in Children With Unilateral Spastic Cerebral Palsy : A Randomized Trial [document électronique] / Yannick Bleyenheuft ; Carlyne Arnould ; Marina B. Brandao ; Corrine Bleyenheuft ; Andrew M. Gordon . - 2014.
Cet article est paru dans le revue Neurorehabilitation and Neural Repair sous le doi: 10.1177/1545968314562109
Langues : Anglais (eng)
Mots-clés : upper extremity rehabilitation lower extremity rehabilitation cerebral palsy bimanual training hand, posture motor skill learning intensive training eurorehabilitation gait dose hemiplegia children Résumé : Background. Intensive bimanual training results in more improvement in hand function in children with unilateral spastic cerebral palsy (USCP) than lower intensity conventional interventions. However, it is not known whether combined upper and lower extremity training in an intensive protocol is more efficacious for upper and lower functional abilities than conventional therapies provided in usual customary care. Objective. To determine the efficacy of Hand and Arm Bimanual Intensive Therapy Including Lower Extremity (HABIT-ILE) for children with USCP. Methods. Twenty-four children with USCP were randomized into 2 groups: an immediate HABIT-ILE group (IHG, initially receiving HABIT-ILE, 10 days = 90 hours), and a delayed HABIT-ILE group (DHG), which continued their conventional/ongoing treatment for an intended total duration of 90 hours. In phase 2, children in the DHG were crossed over to receive HABIT-ILE and children of the IHG were followed in their ongoing conventional therapy. Children were assessed using the Assisting Hand Assessment (AHA, primary outcome), the ABILHAND-Kids, and the Pediatric Evaluation of Disability Inventory. Dexterity (Box and Blocks Test [BBT]) and pinch strength were also measured. Locomotor abilities were assessed with Six-Minute Walk Test (6MWT, primary outcome) and ABILOCO-kids. Social participation was measured with the Assessment of Life-HABITs. Results. A 2 (groups) × 3 (test sessions) analysis of variance indicated significant improvements for primary outcomes (AHA, P < .001; 6MWT, P = .002) and all secondary assessments except BBT, step length and bodyweight distribution following HABIT-ILE, but not conventional therapy. Conclusion. The findings suggest that combined upper and lower extremity in an intensive training protocol may be efficacious for improving both upper and lower extremity function in children with USCP. En ligne : https://journals.sagepub.com/doi/pdf/10.1177/1545968314562109 Permalink : ./index.php?lvl=notice_display&id=98143 Exemplaires
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