Children with scissor gait can benefit
This study supports the effectiveness of the practice of using serial casting in conjunction with botox for treating spastic paraparesis and cerebral palsy in children, where scissor gait is a problem.
Serial casting after botulinum toxin type A treatment can enhance the benefits of the botox in children with scissor gait. Here are good articles on serial casting https://www.childrens.health.qld.gov.au/fact-sheet-serial-casting-lower-limb/ and treatment with botox. https://www.childrens.health.qld.gov.au/fact-sheet-botulinum-toxin-a-treating-spasticity/
The purpose of this study was to examine whether combination therapy of serial casting and botulinum toxin type A injection can further enhance the effects of botulinum toxin type A in children with cerebral palsy with scissoring of both legs.
This study was a prospective and randomized trial. The children were divided into 2 groups, one of which received serial casting after botulinum toxin type A (n = 40), and the other which only received botulinum toxin type A (n = 40). Serial casting started 3 weeks after the botulinum toxin type A. Both groups received physiotherapy.
Groups were assessed at baseline, then compared at 6 and 12 weeks following the intervention. Significant improvements in Gross Motor Function Measure-66 and Caregiver Health Questionnaire were recorded in both groups (P < .001).
The modified Ashworth scale improved significantly following botulinum toxin type A in the serial casting group (P < .05), but not in botulinum toxin type A only group.
These results suggest that serial casting after botulinum toxin type A can enhance the benefits of botulinum toxin type A in children with cerebral palsy.
SOURCE: J Child Neurol. 2017 Jun;32(7):671-675. doi: 10.1177/0883073817701526. Epub 2017 Apr 9. PMID: 28393669
Serial Casting as an Adjunct to Botulinum Toxin Type A Treatment in Children With Cerebral Palsy and Spastic Paraparesis With Scissoring of the Lower Extremities.
Dai AI1, Demiryürek AT2.
1 Department of Pediatric Neurology, Faculty of Medicine, University of Gaziantep, Gaziantep, Turkey.
2 Department of Medical Pharmacology, Faculty of Medicine, University of Gaziantep, Gaziantep, Turkey.