Cerebral Palsy Clinical Trial
Official title:
Integrated Botulinum Toxin for Improved Sitting Balance in Children With Cerebral Palsy: Body Functions to Activity and Participation
The aim of this study is to evaluate the changes in activity and participation domains of International Classification of Functioning, Disability and Health (ICF) in children with cerebral palsy (CP) who received integrated Botulinum Toxin-A (BoNT-A) injections into the lower limb(s) with a treatment goal of improved sitting balance.
Postural problems play a substantial role in activities of daily living in children with CP
having Gross Motor Function Classification System (GMFCS) levels IV or V. Improvement in
sitting balance may positively effect the performance and caregiving of vital tasks of daily
life in these children and may furtherly improve the quality of life of both the child and
family. BoNT-A is an important treatment in children with CP because it is safe in young
children and allows combined treatment. In the current literature its efficacy on body
functions and structures by hypertonia management is well known. However there is
inconclusive evidence for improvement in activity and participation domains of ICF with
BoNT-A. CP is a very heterogenous population and in most of the studies the inclusion
criteria do not adress level of underlying motor control and the primary efficacy assessment
methods were usually chosen to cover hypertonia. Besides generally the efficacy endpoints
were so soon to detect changes in activity or participation domains of ICF. Lack of
association of rehabilitation programs is another important concern for the current clinical
studies.
In this present study a well defined subpopulation of CP children having GMFCS levels of IV
or V who each received integrated BoNT-A treatment with a primary goal of improved sitting
balance will be recruited to identify the probable changes in activity and participation
domains of ICF as well as changes in quality of life of the family and the child.
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