Abstract
Abstract
Background: Cerebral palsy children face walking difficulty due to spasticity and balance problems during prolonged walking. Botulinum Toxin A injections in Gastrocnemius and Soleus show reduced muscle spasticity. However, their effectiveness in improving balance during prolonged walks has yet to be fully established.
Aim: The objective of this study was to evaluate the effect of BoNT A injection on balance and muscle activation in cerebral palsy patients during prolonged walking.
Method: This study is based on a double-blinded placebo control RCT, with 59 participants named as WE study, which was carried out in France, Poland, and Norway. Thirty-three children from the WE study were included in this study, with a 5-minute walk test data where they were instructed to move back and forth at their normal speed for 5 minutes in a 25-meter-long hallway. They wore two EMG electrodes at the gastrocnemius and soleus and four Axivity AX3 activity monitors (back, thigh, right, and left foot) throughout the test. Distance walked was recorded with a measuring wheel. Data was gathered at four different time points: pre-treatment (baseline), at four weeks, at 12 weeks, and 24 weeks following treatment. The participants were analyzed through EMG and accelerometers for muscle activation and balance. RMS-EMG, walking speed, step detection, and sample entropy were the outcome variables calculated from the EMG and acceleration signals captured by the accelerometers, respectively. Statistical analysis was done through SPSS using a linear mixed model and Wilcoxon signed-rank test.
Results: No significant differences were found in the changes from baseline between the BoNT-A and placebo-treated children in any of the variables.
Conclusion: Our study could not confirm a significant improvement or deterioration due to BoNT-A treatment on walking or balance.
Keywords: BoNT A, cerebral palsy, balance, muscle activation, prolonged walk
