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Short-Term Effect of Botulinum Toxin A Injection on Spastic Equinovarus Foot in Cerebral Palsy Patients: A Study Using the Foot Pressure Measurement System

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주제분류재활의학

초록

Objective To evaluate the therapeutic effect of botulinum toxin A (BTX-A) injection on spastic gastrocnemius (GCM) and tibialis posterior muscles (TPo) by using the foot pressure measurement system (FPMS).Methods Eighteen ambulatory CP patients were recruited in this study. BTX-A was injected into the GCM at a dose of 6–12 units/kg and TPo at a dose of 4–9 units/kg according to the severity of equinus and varus deformity. Foot contact pattern, pressure time integral (PTI), coronal index using the FPMS and Modified Ashworth Scale (MAS), and visual inspection of gait pattern were used for evaluation of the therapeutic effect of BTX-A injection. Clinical and FPMS data were statistically analyzed according to the muscle group.Results A significant decrease in the MAS score of the GCM and TPo was observed, and spastic equinovarus pattern during gait showed improvement after injection. The GCM+TPo injection group showed a significant decrease in forefoot, lateral forefoot pad, and lateral column PTI, and a significant increase in hindfoot PTI and coronal index. In the GCM only injection group, forefoot PTI and lateral column PTI were significantly decreased and hindfoot PTI was significantly increased. The TPo only injection group showed a significant decrease in lateral column PTI and a significant increase in the coronal index. Change in PTI in the hindfoot showed a significant correlation with the change in MAS score of the GCM. Change in PTI of the lateral column and coronal index showed a significant correlation with the change in MAS score of the TPo. Conclusion The FPMS demonstrated the quantitative therapeutic effect of BTX-A on abnormal pressure distribution in equinovarus foot in detail. The FPMS can be a useful additional tool for evaluation of the effect of BTX-A injection.

Abstract

Objective To evaluate the therapeutic effect of botulinum toxin A (BTX-A) injection on spastic gastrocnemius (GCM) and tibialis posterior muscles (TPo) by using the foot pressure measurement system (FPMS).Methods Eighteen ambulatory CP patients were recruited in this study. BTX-A was injected into the GCM at a dose of 6–12 units/kg and TPo at a dose of 4–9 units/kg according to the severity of equinus and varus deformity. Foot contact pattern, pressure time integral (PTI), coronal index using the FPMS and Modified Ashworth Scale (MAS), and visual inspection of gait pattern were used for evaluation of the therapeutic effect of BTX-A injection. Clinical and FPMS data were statistically analyzed according to the muscle group.Results A significant decrease in the MAS score of the GCM and TPo was observed, and spastic equinovarus pattern during gait showed improvement after injection. The GCM+TPo injection group showed a significant decrease in forefoot, lateral forefoot pad, and lateral column PTI, and a significant increase in hindfoot PTI and coronal index. In the GCM only injection group, forefoot PTI and lateral column PTI were significantly decreased and hindfoot PTI was significantly increased. The TPo only injection group showed a significant decrease in lateral column PTI and a significant increase in the coronal index. Change in PTI in the hindfoot showed a significant correlation with the change in MAS score of the GCM. Change in PTI of the lateral column and coronal index showed a significant correlation with the change in MAS score of the TPo. Conclusion The FPMS demonstrated the quantitative therapeutic effect of BTX-A on abnormal pressure distribution in equinovarus foot in detail. The FPMS can be a useful additional tool for evaluation of the effect of BTX-A injection.

참고문헌 (38)

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Short-Term Effects of Combined Serial Casting and Botulinum Toxin Injection for Spastic Equinus in Ambulatory Children with Cerebral Palsy김선미, 나동욱, 박은숙, 송상혁, 유준기, 장원혁연세대학교의과대학 · Yonsei Medical Journal2010 · 제51권 제4호Architectural Changes of the Gastrocnemius Muscle after Botulinum Toxin Type A Injection in Children with Cerebral Palsy나동욱, 박은숙, 심은결, 정수진연세대학교의과대학 · Yonsei Medical Journal2014 · 제55권 제5호Comparison of Treatment Effects Between Children With Spastic Cerebral Palsy Under and Over Five Years After Botulinum Toxin Type A Injection권동락, Gi-Young Park, Won-Yub Lee대한재활의학회 · Annals of Rehabilitation Medicine2014 · 제38권 제2호The Change of Intrinsic Stiffness in Gastrocnemius after Intensive Rehabilitation with Botulinum Toxin A Injection in Spastic Diplegic Cerebral Palsy권동락, 박기영, Jung Gu Kwon대한재활의학회 · Annals of Rehabilitation Medicine2012 · 제36권 제3호뇌성마비 환아의 Botulinum Toxin A 주사 후보행양상의 변화김영희, 이재호, 홍도선한국전문물리치료학회 · 한국전문물리치료학회지1998 · 제5권 제1호Effect of Botulinum Toxin Injection in Hip Adductor Muscles on Gross Motor Function in Low-Functioning Children with Spastic Cerebral Palsy나동욱, 유제현, 이주희, 조예빈, 차준민, 홍준택연세대학교의과대학 · Yonsei Medical Journal2026 · 제67권 제1호

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