Robot-mediated and clinical scales evaluation after upper limb botulinum toxin type A injection in children with hemiplegia.

Full Abstract

OBJECTIVE: The aim of this pilot study was to examine changes in different aspects of impairment, including spasticity in the upper limbs, of hemiplegic children following botulinum toxin type A intervention. Progress was assessed using standard clinical measurements and a robotic device. DESIGN: Pre-post multiple baseline. SUBJECTS: Six children with hemiplegia. METHODS: Botulinium toxin type A injections were administered into the affected upper limb muscles. Outcomes were evaluated before and one month after the injection. Outcome assessments included: Melbourne Scale, Modified Ashworth Scale (MAS) and Passive Range of Motion. Furthermore, a robotic device was employed as an evaluation tool. RESULTS: Patients treated with botulinum toxin type A had significantly greater reduction in spasticity (MAS, p < 0.01), which explains an improvement in upper limb function and quality movement measured with the Melbourne Scale (p < 0.01). These improvements are consistent with robot-based evaluation results that showed statistically significant changes (p < 0.01) following botulinum toxin type A injections. CONCLUSION: The upper limb performs a wide variety of movements. The multi-joint nature of the task during the robot-mediated evaluation required active control of joint interaction forces. There was good correlation between clinical scales and robotic evaluation. Hence the robot-mediated assessment may be used as an additional tool to quantify the degree of motor improvement after botulinum toxin type A injections.

Author information

Author/s: Frascarelli, Flaminia (F); Masia, Lorenzo (L); Di Rosa, Giuseppe (G); Petrarca, Maurizio (M); Cappa, Paolo (P); Castelli, Enrico (E);

Affiliation: Pediatric Neuro-Rehabilitation Division, Children's Hospital Bambino Gesù IRCCS Via Torre di Palidoro, IT-00050 Passoscuro (Fiumicino) Rome, Italy. flaminiafrascarelli(-atsign-)opbg.net

Journal and publication information

Publication Type: Journal Article

Journal: Journal of rehabilitation medicine : official journal of the UEMS European Board of Physical and Rehabilitation Medicine (J Rehabil Med), published in Sweden. (Language: eng)

Reference: 2009-Nov; vol 41 (issue 12) : pp 988-94

Dates: Created 2009/10/20; Completed 2009/10/27;

PMID: 19841830, status: MEDLINE (last retrieval date: 10/27/2009, IMS Date: )

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