Treatment with Botulinum toxin A in a total population of children with cerebral palsy - a retrospective cohort registry study

BMC Musculoskeletal Disorders

Research Article

Gunnar Hägglund¹  Ann Alriksson-Schmidt¹  Maria Franzén² 

[1] Department of Clinical Sciences Lund, Orthopedics, Skåne University Hospital, Lund University, Lund, Sweden;Faculty of Medicine, Lund University, Lund, Sweden;

关键词: Cerebral palsy;    Spasticity;    Botulinum toxin a;    CPUP;    Age;    Sex;    GMFCS level;    Registry;   

DOI  :  10.1186/s12891-017-1880-y

 received in 2017-03-27, accepted in 2017-11-28,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundBotulinum toxin A (BTX-A) has been used to reduce spasticity in children with cerebral palsy (CP) for decades. The purpose of this study was to analyze to what extent BTX-A treatment was used to treat spasticity in a total population of children with CP. We investigated 1) the use of BTX-A in relation to age, sex, and Gross Motor Function Classification System (GMFCS) level, 2) the most common muscle groups treated with BTX-A in relation to the same variables, and 3) changes in the proportions of children treated with BTX-A between two time points (2010 and 2015).MethodsThe study was based on data from CPUP, a combined Swedish follow-up program and national healthcare registry, comprising >95% of all children with CP in Sweden. The participants (N = 3028) were born in 2000 or later. Potential BTX-A treatment and treated muscle groups were included from all CPUP assessments recorded in the registry in 2014–2015. In Aim 3, BTX-A administration in 3–5 year-olds at two time points was assessed. Crosstabs and 95% confidence intervals (CIs) for binominal proportions were calculated and logistic regression was used to regress age, sex, and GMFCS level on BTX-A treatment. Muscle groups treated with BTX-A were assessed using crosstabs and 95% CIs. Proportional change in BTX-A treatment over a 5-year period was analyzed using chi-square.ResultsWe included 3028 children (57% boys; median age 7 years) of whom 26% received BTX-A. Significantly more boys (28%) than girls (23%) received BTX-A (OR = 1.25, [95% CI 1.05–1.48]). Significant differences were found for age and GMFCS levels; 4–6 year-olds and those at GMFCS III-IV were more likely to receive BTX-A. BTX-A treatment in the gastrocnemius muscle was most common in the 4–6 year-olds and at GMFCS I-III, whereas treatment of the hamstring and adductor muscles was more common in older children and at GMFCS IV-V. No significant change in the proportion of BTX-A administered in 2010 and 2015 was demonstrated.ConclusionsBTX-A treatment differed based on age, sex, and GMFCS level. Proportion of BTX-A treatment in Sweden has remained stable during the past five years.

【 授权许可】

CC BY   
© The Author(s). 2017