Journal of Rheumatology and Medical Rehabilitation, cilt.16, sa.4, ss.243-249, 2005 (Scopus)
The aim of this study was to determine whether intramuscular Botulinum toxin-A injection into the gastrocnemius muscle can improve walking in cerebral palsied children with equinus gait. 10 children (5 of them were diplegic, 3 of them were left hemiplegic, 2 of them were right hemiplegic) with cerebral palsy and equinus gait were included into the study. The assessment of each patient was done at baseline and 1, 6 and 12 weeks post injection. Passive ankle dorsiflexion was measured goniometrically with the knee extended and 90° flexed. The assessments of dynamic walking was done before the treatment and at 12 weeks after by using 3-dimension computerized motion analysis system. Both passive ankle joint measurements at 6th week and 12th week were statistically different from the baseline(p<0.05). However, no significant change was determined among measurements of dynamic ankle range of motion in gait analysis (p>0.05). Kinematic parameters of ankle dorsiflexion at initial contact, first 10% part of stance and mid-stance were improved significantly (p < .05). At the same time, ankle plantar flexion measurements at terminal stance and maximum dorsiflexion angle at swing phase were improved (p<.05). In conclusion, Botulinum toxin-A injection into the gastrocnemius muscles can improve not only passive ankle joint motion, but also functional movement pattern in some children with cerebral palsy and equinus gait.