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Efficacy of radial extracorporeal shock wave therapy compared with botulinum toxin type A injection in treatment of lower extremity spasticity in subjects with cerebral palsy: A randomized, controlled, cross-over study.

桡动脉体外休克治疗与 a型肉毒毒素注射治疗脑瘫受试者下肢痉挛的疗效比较: 一项随机、对照、交叉研究。

  • 影响因子:2.17
  • DOI:10.2340/16501977-2703
  • 作者列表:"Vidal X","Martí-Fàbregas J","Canet O","Roqué M","Morral A","Tur M","Schmitz C","Sitjà-Rabert M
  • 发表时间:2020-06-11
Abstract

OBJECTIVES:To investigate whether botulinum toxin type A (BTX-A) injection is more effective than radial extracorporeal shock wave therapy in reducing plantar flexor muscle spasticity in subjects with cerebral palsy. METHODS:A total of 68 subjects with cerebral palsy were randomly allocated to BTX-A injection (Group 1) or radial extracorporeal shock wave therapy (Group 2) (first experiment; E1). Outcome was evaluated using the Tardieu V1 and V3 stretches, at 3 weeks, 2 months (M2) and M3 after baseline. At M6 subjects in Group 1 received radial extracorporeal shock wave therapy and subjects in Group 2 received BTX-A injection (second experiment; E2); outcome was evaluated as in E1. Treatment success was defined as improvement in foot dorsiflexion ≥10° when performing the V3 stretch at M2 in both experiments. RESULTS:In both experiments mean V1 and V3 significantly improved over time. In E1 both treatments resulted in similar treatment success. In E2 fewer subjects treated with BTX-A injection reached the criteria of treatment success than did subjects treated with radial extracorporeal shock wave therapy, which was due to a carry-over effect from E1. No significant complications were observed. CONCLUSION:BTX-A injection is not superior to radial extracorporeal shock wave therapy in the treatment of plantar flexor muscle spasticity in subjects with cerebral palsy.

摘要

目的: 探讨 a型肉毒毒素 (BTX-A) 注射在减少脑瘫患者足底屈肌痉挛方面是否比放射状体外休克疗法更有效。 方法: 68 例脑瘫患者随机分为 BTX-A 注射组 (1 组) 和放射状体外休克治疗组 (2 组) (首次实验; E1)。在基线后 3 周、 2 个月 (M2) 和 M3 时,使用 Tardieu V1 和 V3 延伸评价结局。在 M6,第 1 组受试者接受径向体外休克治疗,第 2 组受试者接受 BTX-A 注射 (第二次实验; E2); 按 e1 评价结局。治疗成功定义为在两个实验中在 M2 处进行 V3 拉伸时足部背屈 ≥ 10 ° 的改善。 结果: 在两个实验中,平均 V1 和 V3 随时间显著改善。在 E1 中,两种治疗均获得相似的治疗成功。在 E2 中,接受 BTX-A 注射治疗的受试者比接受放射状体外休克治疗的受试者少达到治疗成功的标准,这是由于 e1 的延续效应。未观察到明显的并发症。 结论: BTX-A 注射治疗脑瘫患者足底屈肌痉挛状态并不优于桡动脉休克治疗。

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作者列表:["Bertrand SJ","Zhang Z","Patel R","O'Ferrell C","Punjabi NM","Kudchadkar SR","Kannan S"]

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