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Medial gastrocnemius volume and echo-intensity after botulinum neurotoxin A interventions in children with spastic cerebral palsy.

Schless, S-H, Cenni, F, Bar-On, L, Hanssen, B, Kalkman, B, O'Brien, TD, Aertbeliën, E, Van Campenhout, A, Molenaers, G and Desloovere, K (2018) Medial gastrocnemius volume and echo-intensity after botulinum neurotoxin A interventions in children with spastic cerebral palsy. Developmental Medicine & Child Neurology. ISSN 1469-8749

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Three or more BoNTA interventions are associated with altered medial gastrocnemius volume and echo-intensity in children with spastic cerebral palsy.pdf - Accepted Version
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Abstract

AIM: This cross-sectional investigation evaluated whether recurrent botulinum neurotoxin A (BoNT-A) interventions to the medial gastrocnemius have an influence on muscle morphology, beyond Gross Motor Function Classification System (GMFCS) level. METHOD: A cohort of typically developing children (n=67; 43 males, 24 females; median age 9y 11mo [range 7y 10mo-11y 6mo]), a cohort of children with spastic cerebral palsy (CP) naive to BoNT-A interventions (No-BoNT-A; n=19; 10 males, nine females; median age 9y 3mo [range 8y 5mo-10y 10mo]) and a cohort of children with spastic CP with a minimum of three recurrent BoNT-A interventions to the medial gastrocnemius (BoNT-A; n=19; 13 males, six females; median age 9y 8mo [range 7y 3mo-10y 7mo]) were recruited. Three-dimensional freehand ultrasound was used to estimate medial gastrocnemius volume normalized to body mass and echo-intensity. RESULTS: Normalized medial gastrocnemius volume and echo-intensity significantly differed between the two spastic CP cohorts (p≤0.05), with the BoNT-A cohort having larger alterations. Associations between normalized medial gastrocnemius volume and echo-intensity were highest in the No-BoNT-A cohort, followed by the BoNT-A cohort. Multiple regression analyses revealed that both GMFCS level and BoNT-A intervention history were significantly associated with smaller normalized medial gastrocnemius volume and higher echo-intensity. INTERPRETATION: Recurrent BoNT-A interventions may induce alterations to medial gastrocnemius volume and echo-intensity beyond the natural history of the spastic CP pathology. WHAT THIS PAPER ADDS: In spastic cerebral palsy, medial gastrocnemius volumes are smaller and echo-intensities higher compared with typical development. Alterations after botulinum neurotoxin A intervention (BoNT-A) are larger than in no BoNT-A intervention. Gross Motor Function Classification System level and BoNT-A history significantly associate with medial gastrocnemius and echo-intensity alterations.

Item Type: Article
Additional Information: This is the peer reviewed version of the following article: Schless, S. , Cenni, F. , Bar‐On, L. , Hanssen, B. , Kalkman, B. , O'brien, T. , Aertbeliën, E. , Van Campenhout, A. , Molenaers, G. and Desloovere, K. (2018), Medial gastrocnemius volume and echo‐intensity after botulinum neurotoxin A interventions in children with spastic cerebral palsy. Dev Med Child Neurol. doi:10.1111/dmcn.14056, which has been published in final form at http://dx.doi.org/10.1111/dmcn.14056. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions.
Uncontrolled Keywords: 11 Medical and Health Sciences
Subjects: R Medicine > RJ Pediatrics > RJ101 Child Health. Child health services
Divisions: Sport & Exercise Sciences
Publisher: Wiley
Related URLs:
Date Deposited: 14 Jan 2019 10:29
Last Modified: 14 Jan 2019 15:09
DOI or Identification number: 10.1111/dmcn.14056
URI: http://researchonline.ljmu.ac.uk/id/eprint/9934

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