• Sebahat Aydil, Fatma Merih Akpinar, Evren Akpinar, Kubilay Beng, and Mehmet Firat Yagmurlu.
• Physical Therapy and Rehabilitation, Gait Analysis Laboratory, Metin Sabanci Baltalimani Bone Diseases Education and Research Hospital, Istanbul, Turkey, drsebahataydil@yahoo.com.
• Med Princ Pract. 2019 Jan 1; 28 (4): 309-314.

ObjectiveThe aim of the present study was to evaluate the effectiveness of multilevel Botulinum Toxin A (BTX-A) injection, as part of an integrated approach, for the treatment of spasticity in non-ambulatory young children with diplegic cerebral palsy (CP).Subjects And MethodsSeventeen non-ambulatory patients aged 4-8 years with diplegic CP (Gross Motor Function Classification System [GMFCS] level IV) were evaluated before and at 1st, 3rd, and 6th months after BTX-A injection. The effect of BTX-A on spasticity of gastrocnemius and hamstring muscles was assessed using the Modified Ashworth Scale (MAS) and Modified Tardieu Scale (MTS). The velocity-dependent properties of spastic muscle as both slow (R2) and fast (R1) stretches were evaluated in MTS.ResultsA statistically significant improvement was observed in R1 angles of gastrocnemius and hamstring muscles at 1st and 3rd months after BTX-A injection in non-ambulatory young children with CP. Statistically significant improvement was found in MAS of gastrocnemius and hamstring muscles and R2 angles of knee and ankle joint after 1st month of BTX-A injection.ConclusionMultilevel BTX-A injection, as part of an integrated approach, can be used for focal treatment of spasticity, especially of hamstring and gastrocnemius muscles, in non-ambulatory young children with CP GMFCS level IV.© 2019 The Author(s) Published by S. Karger AG, Basel.

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