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Upper-Limb Movement Training in Children Following Injection of Botulinum Toxin A Multiple Sclerosis

  • Chapter
International Handbook of Occupational Therapy Interventions

Abstract

Botulinum Neurotoxin A (BoNT-A) is a useful medication for the reduction of spasticity and dystonia in the upper limb of children with cerebral palsy (CP). The method of toxin delivery, dose, and muscle selection criteria are established. Children who are being treated require appropriate assessment at the impairment and activity levels of functioning. Once injected, children require specific therapy delivered by an occupational therapist (OT) according to the specified goals of the intervention set out, prior to injection, by the child, family, and health care workers. Botulinum neurotoxin injection offers the child with cerebral palsy a window of opportunity in which to develop further skills in upper limb functioning. Further research using rigorous scientific design evaluating specific therapy regimes and other interventions is required to enable more specific protocols to be established.

After injection and intensive therapy, the client was really happy to be able to catch and throw a ball with his school friends.

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References

  • Ahl, L. E., Johansson, E., Granat, T., & Carlberg, E. B. (2005). Functional therapy for children with cerebral palsy: an ecological approach. Dev Med Child Neurol, 47(9), 613–619

    PubMed  Google Scholar 

  • Autti-Ramo, I., Larsen, A., Taimo, A., & von Wendt, L. (2001). Management of the upper limb with botulinum toxin type A in children with spastic type cerebral palsy and acquired brain injury: clinical implications. European Journal of Neurology, 8 Suppl 5, 136–144

    Article  Google Scholar 

  • Bax, M., Goldstein, M., Rosenbaum, P., Leviton, A., Paneth, N., Dan, B., et al. (2005). Proposed definition and classification of cerebral palsy, April 2005. Dev Med Child Neurol, 47(8), 571–576

    Google Scholar 

  • Boyd, R. (2004). The central and peripheral effects of botulinum toxin A in children with cerebral palsy PhD dissertation, La Trobe University, Melbourne

    Google Scholar 

  • Boyd, R. N., & Graham, H. K. (1999). Objective measurement of clinical finding in the use of botulinum toxin type A for the managment of children with cerebral palsy. Eur J Neurol, 6(Suppl. 4), S23–S35

    Article  Google Scholar 

  • Brin, M. F. (1997). Botulinum toxin: chemistry, pharmacology, toxicity, and immunology. Muscle Nerve Suppl, 6, S146–168

    Article  PubMed  CAS  Google Scholar 

  • Chapparo, C., & Ranka, J. (1997). Occupational Performance Model (Australia) (Vol. Monograph 1). Sydney: OP Network - Total Print Control

    Google Scholar 

  • Charles, J., & Gordon, A. M. (2006). Development of hand-arm bimanual intensive training (HABIT) for improving bimanual coordination in children with hemiplegic cerebral palsy. Dev Med Child Neurol, 48(11), 931–936

    Article  PubMed  Google Scholar 

  • Corn, K., Imms, C., Timewell, G., Carter, C., Collins, L., Dubbeld, S., ,et al. (2003). Impact of second skin Lycra splinting on quality of upper limb movement in children. British Journal of Occupational Therapy., 66, 464–472

    Google Scholar 

  • Eliasson, A. C. (2005). Improving the use of hands in daily activities: aspects of the treatment of children with cerebral palsy. Phys Occup Ther Pediatr 25(3), 37–60

    PubMed  Google Scholar 

  • Eliasson, A. C., Krumlinde-Sundholm, L., Rosblad, B., Beckung, E., Arner, M., Ohrvall, A. M., , et al. (2006). The Manual Ability Classification System (MACS) for children with cerebral palsy: scale development and evidence of validity and reliability. Dev Med Child Neurol 48(7), 549–554

    Article  PubMed  Google Scholar 

  • Graham, H. K. (2000). Botulinum toxin A in cerebral palsy: functional outcomes.[comment]. Journal of Pediatrics, 137(3), 300–303

    Article  PubMed  CAS  Google Scholar 

  • Greaves, S. (2004). The effect of botulinum toxin A injections on occupational therapy intervention outcomes for children with spastic hemiplegia., La Trobe University, Melbourne

    Google Scholar 

  • Hoare, B. J., Wasiak, J., Imms, C., & Carey, L. (2007). Constraint-induced movement therapy in the treatment of the upper limb in children with hemiplegic cerebral palsy. Cochrane Database Syst Rev(2), CD004149

    Google Scholar 

  • Jankovic, J., & Brin, M. F. (1997). Botulinum toxin: historical perspective and potential new indications. Muscle Nerve Suppl 6, S129–145

    Article  PubMed  CAS  Google Scholar 

  • Kaplan, M. T., & Bedell, G. (1999). Motor skill acquisition frame of reference. In P. Kramer & J. Hinojosa (Eds.), Frames of Reference for Pediatric Occupational Therapy, (2nd ed., pp. 401–429). Baltimore: Williams and Wilkins

    Google Scholar 

  • Ketelaar, M., Vermeer, A., Hart, H., van Petegem-van Beek, E., & Helders, P. J. (2001). Effects of a functional therapy program on motor abilities of children with cerebral palsy. Phys Ther, 81(9), 1534–1545

    PubMed  CAS  Google Scholar 

  • Kielhofner, G. (1995). A Model of Human Occupation. Theory and Application (2nd ed.). Baltimore: Williams and Wilkins

    Google Scholar 

  • Kiresuk, T. J., Smith, J. E., & Cardillo, J. E. (1994). Goal Attainment Scaling: Applications, Theory and Measurement, Hillsdale, NJ: Lawrence Erlbaum

    Google Scholar 

  • Knox, V. (2003). The use of Lycra garments in children with cerebral palsy: A report of a descriptive clinical trial. British Journal of Occupational Therapy., 66, 71–77

    Google Scholar 

  • Krumlinde-Sundholm, L., Holmefur, M., Kottorp, A., & Eliasson, A. C. (2007). The Assisting Hand Assessment: current evidence of validity, reliability, and responsiveness to change. Dev Med Child Neurol, 49(4), 259–264

    Article  PubMed  Google Scholar 

  • Lannin, N. A., Novak, I., & Cusick, A. (2007). A systematic review of upper extremity casting for children and adults with central nervous system motor disorders. Clin Rehabil, 21(11), 963–976

    Article  PubMed  CAS  Google Scholar 

  • Law, M., Baptiste, S., Carswell, A., McColl, M. A., Polatajko, H., & Pollock, N. (1994). The Canadian Occupational Performance Measure. (2nd ed.). Toronto: Canadian Association of Occupational Therapists

    Google Scholar 

  • Law, M., Stanton, S., Polatajko, H., Baptiste, S., Thompson-Franson, T., Kramer, C., et al. (1997). Enabling Occupation. An occupational therapy perspective. Ottawa: CAOT Publications

    Google Scholar 

  • Light, K. E., Nuzik, S., Personius, W., & Barstrom, A. (1984). Low-load prolonged stretch vs. high-load brief stretch in treating knee contractures. Phys Ther, 64(3), 330–333

    PubMed  CAS  Google Scholar 

  • Lowe, K., Novak, I., & Cusick, A. (2006). Low-dose/high-concentration localized botulinum toxin A improves upper limb movement and function in children with hemiplegic cerebral palsy. Dev Med Child Neurol, 48(3), 170–175

    Article  PubMed  Google Scholar 

  • Mackey, A. H., Walt, S. E., Lobb, G., & Stott, N. S. (2004). Intraobserver reliability of the modified Tardieu scale in the upper limb of children with hemiplegia. Dev Med Child Neurol, 46(4), 267–272

    Article  PubMed  Google Scholar 

  • Mastos, M., Miller, K., Eliasson, A. C., & Imms, C. (2007). Goal-directed training: linking theories of treatment to clinical practice for improved functional activities in daily life. Clin Rehabil, 21(1), 47–55

    Article  PubMed  CAS  Google Scholar 

  • Minamoto, V. B., Hulst, J. B., Lim, M., Peace, W. J., Bremner, S. N., Ward, S. R., , et al. (2007). Increased efficacy and decreased systemic-effects of botulinum toxin A injection after active or passive muscle manipulation. Dev Med Child Neurol, 49(12), 907–914

    Article  PubMed  Google Scholar 

  • Morris, D. M., & Taub, E. (2001). Constraint-induced therapy approach to restoring function after neurological injury. Top Stroke Rehabil, 8(3), 16–30

    Article  PubMed  CAS  Google Scholar 

  • Nicholson, J. H., Morton, R. E., Attfield, S., & Rennie, D. (2001). Assessment of upper-limb function and movement in children with cerebral palsy wearing Lycra garments. Developmental Medicine & Child Neurology, 43(6), 384–391

    Article  CAS  Google Scholar 

  • O’Brien, C. F. (1997). Injection techniques for botulinum toxin using electromyography and electrical stimulation. Muscle Nerve Suppl, 6, S176–180

    PubMed  Google Scholar 

  • Pin, T., Dyke, P., & Chan, M. (2006). The effectiveness of passive stretching in children with cerebral palsy. Dev Med Child Neurol, 48(10), 855–862

    Article  PubMed  Google Scholar 

  • Randall, M., Carlin, J. B., Chondros, P., & Reddihough, D. (2001). Reliability of the Melbourne assessment of unilateral upper limb function. Developmental Medicine & Child Neurology, 43(11), 761–767

    Google Scholar 

  • Reddihough, D. S., & Collins, K. J. (2003). The epidemiology and causes of cerebral palsy. Australian Journal of Physiotherapy, 49(1), 7–12

    Google Scholar 

  • Russman, B. S., Tilton, A., & Gormley, M. E., Jr. (1997). Cerebral palsy: a rational approach to a treatment protocol, and the role of botulinum toxin in treatment. Muscle Nerve Suppl, 6, S181–193

    Article  PubMed  CAS  Google Scholar 

  • Russo, R. N., Crotty, M., Miller, M. D., Murchland, S., Flett, P., & Haan, E. (2007). Upper-limb botulinum toxin A injection and occupational therapy in children with hemiplegic cerebral palsy identified from a population register: a single-blind, randomized, controlled trial. Pediatrics, 119(5), e1149–1158

    Article  PubMed  Google Scholar 

  • Schmidt, R. A., & Lee, T. D. (1999). Motor control and learning: a behavioural emphasis, 2nd ed.. Champaign, IL: Human Kinetics Publishers

    Google Scholar 

  • Steenbergen, B., & Gordon, A. M. (2006). Activity limitation in hemiplegic cerebral palsy: evidence for disorders in motor planning. Dev Med Child Neurol, 48(9), 780–783

    Article  PubMed  Google Scholar 

  • Steenbergen, B., Verrel, J., & Gordon, A.M. (2007). Motor planning in congenital hemiplegia. Disabil Rehabil, 29(1), 13–23

    Article  PubMed  Google Scholar 

  • Steffen, T. M., & Mollinger, L. A. (1995). Low-load, prolonged stretch in the treatment of knee flexion contractures in nursing home residents. Phys Ther, 75(10), 886–895; discussion 895–887

    PubMed  CAS  Google Scholar 

  • Taft, L. T. (1995). Cerebral Palsy. Pediatrics in Review, 16(11), 411–418; quiz 418

    CAS  Google Scholar 

  • Tardieu, C., Lespargot, A., Tabary, C., & Bret, M. D. (1988). For how long must the soleus muscle be stretched each day to prevent contracture? Dev Med Child Neurol, 30(1), 3–10

    Article  PubMed  CAS  Google Scholar 

  • Taub, E., Uswatte, G., & Pidikiti, R. (1999). Constraint-Induced Movement Therapy: a new family of techniques with broad application to physical rehabilitation--a clinical review. J Rehabil Res Dev, 36(3), 237–251

    PubMed  CAS  Google Scholar 

  • Wallen, M., O’Flaherty, S. J., & Waugh, M. C. (2007). Functional outcomes of intramuscular botulinum toxin type a and occupational therapy in the upper limbs of children with cerebral palsy: a randomized controlled trial. Arch Phys Med Rehabil, 88(1), 1–10

    Article  PubMed  Google Scholar 

  • Williams, P. E. (1988). Effect of intermittent stretch on immobilised muscle. British Medical Journal., 47, 1014–1016

    CAS  Google Scholar 

  • Williams, P. E., Catanese, T., Lucey, E.G., & Goldspink, G. (1988). The importance of stretch and contractile activity in the prevention of connective tissue accumulation in muscle. J Anat, 158, 109–114

    PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Pediatric Rehabilitation Service, Monash Medical Centre, Clayton, Australia

    Brian Hoare & Remo N. Russo

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  1. Brian Hoare
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  2. Remo N. Russo
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Ingrid Söderback

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Hoare, B., Russo, R. (2009). Upper-Limb Movement Training in Children Following Injection of Botulinum Toxin A Multiple Sclerosis. In: Söderback, I. (eds) International Handbook of Occupational Therapy Interventions. Springer, New York, NY. https://doi.org/10.1007/978-0-387-75424-6_35

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  • DOI: https://doi.org/10.1007/978-0-387-75424-6_35

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-0-387-75423-9

  • Online ISBN: 978-0-387-75424-6

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