Current Physiotherapy and Rehabilitation Approaches After Botulinum Toxin Injection in Cerebral Palsy

Öz

Cerebral Palsy (CP) is an umbrella term that refers to a set of disorders that result in problems with posture and movement following permanent damage to the newborn's immature brain. Botulinum Toxin (BoNT) injections are frequently used in the management of spasticity, which is an important and very common disorder in CP. Although BoNT injections alone reduce local spasticity for a certain period of time, various physiotherapy and rehabilitation applications are needed to maintain the gains achieved and improve functions. However, there is no consensus in the literature regarding physiotherapy and rehabilitation practices after BoNT injections. The aim of this review is to summarize the current physiotherapy and rehabilitation approaches applied after BoNT injections into spastic muscles in individuals with CP, to examine their place in the literature by emphasizing their level of evidence, and to summarize their effectiveness.

Anahtar Kelimeler

• Cerebral palsy
• Botulinum toxin
• Physiotherapy
• Rehabilitation

Serebral Palside Botulinum Toksin Enjeksiyonu Sonrası Güncel Fizyoterapi ve Rehabilitasyon Yaklaşımları

Öz

Serebral Palsi (SP) yenidoğanın gelişmemiş beyninde meydana gelen kalıcı bir hasarın ardından postür ve harekette problemlerle sonuçlanan bir dizi bozukluğu ifade eden şemsiye bir terimdir. SP’de önemli ve oldukça sık görülen bir bozukluk olan spastisitenin yönetiminde Botulinum Toksin (BoNT) enjeksiyonlarından sıklıkla faydalanılmaktadır. BoNT enjeksiyonları tek başına lokal spastisiteyi belli bir süreliğine azaltsa da, elde edilen kazanımların korunması ve fonksiyonların iyileştirilmesi için çeşitli fizyoterapi ve rehabilitasyon uygulamalarına ihtiyaç duyulur. Ancak literatürde BoNT enjeksiyonları sonrası fizyoterapi ve rehabilitasyon uygulamalarına yönelik bir uzlaşı bulunmamaktadır. Bu derlemenin amacı SP’li bireylerde spastik kaslara yapılan BoNT enjeksiyonlarının ardından uygulanan güncel fizyoterapi ve rehabilitasyon yaklaşımlarının özetlenmesi, literatürdeki yerlerinin kanıt düzeyleri vurgulanarak incelenmesi ve etkinliklerinin özetlenmesidir.

Anahtar Kelimeler

• Serebral palsi
• Botulinum toksin
• Fizyoterapi
• Rehabilitasyon

Kaynakça

1. 1. Bax, M. C. (1964). Terminology and classification of cerebral palsy. Developmental Medicine & Child Neurology, 6(3), 295-297. 2. Rosenbaum, P., Paneth, N., Leviton, A., Goldstein, M., Bax, M., Damiano, D., & et al. (2007). A report: the definition and classification of cerebral palsy April 2006. Developmental Medicine & Child Neurology, 109(suppl 109), 8-14.
2. 3. Cans, C., Dolk, H., Platt, M. J., & Colver, A. (2007). Recommendations from the SCPE collaborative group for defining and classifying cerebral palsy. Developmental Medicine & Child Neurology, 49, 35.
3. 4. Bar-On, L., Molenaers, G., Aertbeliën, E., Van Campenhout, A., Feys, H., Nuttin, B., & et al. (2015). Spasticity and its contribution to hypertonia in cerebral palsy. BioMed Research International, 2015.
4. 5. Lance, J. W. (1980). Symposium synopsis. Spasticity: Disordered Motor Control, 487-489.
5. 6. Shamsoddini, A., Amirsalari, S., Hollisaz, M.-T., Rahimnia, A., & Khatibi-Aghda, A. (2014). Management of spasticity in children with cerebral palsy. Iranian Journal of Pediatrics, 24(4), 345.
6. 7. Tickner, N., Apps, J. R., Keady, S., & Sutcliffe, A. G. (2012). An overview of drug therapies used in the treatment of dystonia and spasticity in children. Archives of Disease in Childhood-Education and Practice, 97(6), 230-235.
7. 8. Simon, O., & Yelnik, A. (2010). Managing spasticity with drugs. European Journal of Physical and Rehabilitation Medicine, 46(3), 401-410.
8. 9. Koman, L. A., Mooney III, J. F., Smith, B. P., Goodman, A., & Mulvaney, T. (1994). Management of spasticity in cerebral palsy with botulinum-A toxin: report of a preliminary, randomized, double-blind trial. Journal of Pediatric Orthopaedics, 14(3), 299-303.

9. 10. Novak, I., Morgan, C., Fahey, M., Finch-Edmondson, M., Galea, C., Hines & et al. (2020). State of the evidence traffic lights 2019: systematic review of interventions for preventing and treating children with cerebral palsy. Current Neurology and Neuroscience Reports, 20, 1-21.
10. 11. Novak, I., Mcintyre, S., Morgan, C., Campbell, L., Dark, L., Morton, N., & et al. (2013). A systematic review of interventions for children with cerebral palsy: state of the evidence. Developmental Medicine & Child Neurology, 55(10), 885-910.
11. 12. Mathevon, L., Bonan, I., Barnais, J.-L., Boyer, F., & Dinomais, M. (2019). Adjunct therapies to improve outcomes after botulinum toxin injection in children: A systematic review. Annals of Physical and Rehabilitation Medicine, 62(4), 283-290.
12. 13. Barnes, M. P., & Johnson, G. R. (2001). Upper motor neurone syndrome and spasticity: Clinical management and neurophysiology: Cambridge University Press.
13. 14. Gage, J. R., Schwartz, M. H., Koop, S. E., & Novacheck, T. F. (2009). The identification and treatment of gait problems in cerebral palsy: John Wiley & Sons.
14. 15. Klingels, K., Demeyere, I., Jaspers, E., De Cock, P., Molenaers, G., Boyd, R., & et al. (2012). Upper limb impairments and their impact on activity measures in children with unilateral cerebral palsy. European Journal of Paediatric Neurology, 16(5), 475-484.
15. 16. Scott, A. B. (1980). Botulinum toxin injection into extraocular muscles as an alternative to strabismus surgery. Ophthalmology, 87(10), 1044–1049.
16. 17. Whurr, R., Lorch, M., Fontana, H., Brookes, G., Lees, A., & Marsden, C. (1993). The use of botulinum toxin in the treatment of adductor spasmodic dysphonia. Journal of Neurology, Neurosurgery & Psychiatry, 56(5), 526-530.
17. 18. Aoki, K., & Guyer, B. (2001). Botulinum toxin type A and other botulinum toxin serotypes: a comparative review of biochemical and pharmacological actions. European Journal of Neurology, 8, 21-29.
18. 19. Cosgrove, A., & Graham, H. (1994). Botunum toxin a prevents the development of contractures in the hereditary spastc mouse. Developmental Medicine & Child Neurology, 36(5), 379-385.
19. 20. Kay, R. M., Rethlefsen, S. A., Fern-Buneo, A., Wren, T. A., & Skaggs, D. L. (2004). Botulinum toxin as an adjunct to serial casting treatment in children with cerebral palsy. The Journal of Bone & Joint Surgery 86(11), 2377-2384.
20. 21. Lee, S. J., Sung, I. Y., Jang, D. H., Yi, J. H., Lee, J. H., & Ryu, J. S. (2011). The effect and complication of botulinum toxin type A injection with serial casting for the treatment of spastic equinus foot. Annals of Rehabilitation Medicine, 35(3), 344-353.
21. 22. Picelli, A., Santamato, A., Chemello, E., Cinone, N., Cisari, C., Gandolfi, M., & et al. (2019). Adjuvant treatments associated with botulinum toxin injection for managing spasticity: An overview of the literature. Annals of Physical and Rehabilitation Medicine, 62(4), 291-296.
22. 23. Valentine, J., Stannage, K., Fabian, V., Ellis, K., Reid, S., & et al. (2016). Muscle histopathology in children with spastic cerebral palsy receiving botulinum toxin type A. Muscle & Nerve, 53(3), 407-414.
23. 24. De Beukelaer, N., Weide, G., Huyghe, E., Vandekerckhove, I., Hanssen, B., Peeters, N. et al. (2022). Reduced cross-sectional muscle growth six months after botulinum toxin type-A injection in children with spastic cerebral palsy. Toxins, 14(2), 139.
24. 25. Bovend'Eerdt, T. J., Newman, M., Barker, K., Dawes, H., Minelli, C., & Wade, D. T. (2008). The effects of stretching in spasticity: a systematic review. Archives of Physical Medicine and Rehabilitation, 89(7), 1395-1406.
25. 26. Smania, N., Picelli, A., Munari, D., Geroin, C., Ianes, P., Waldner, A., & Gandolfi, M. (2010). Rehabilitation procedures in the management of spasticity. Eur J Phys Rehabil Med, 46(3), 423-438.
26. 27. Mills, P. B., Finlayson, H., Sudol, M., & O’Connor, R. (2016). Systematic review of adjunct therapies to improve outcomes following botulinum toxin injection for treatment of limb spasticity. Clinical Rehabilitation, 30(6), 537-548.
27. 28. Franceschini, M., Iocco, M., Molteni, F., Santamato, A., & Smania, N. (2014). Management of stroke patients submitted to botulinum toxin type A therapy: a Delphi survey of an Italian expert panel of specialist injectors. European Journal of Physical and Rehabilitation Medicine, 50(5), 525-533.
28. 29. Picelli, A., Smania, N., Storti, I., Munari, D., Fontana, C., Fiaschi, A., & et al. (2011). Immediate versus delayed electrical stimulation boosts botulinum toxin effect: A pilot study. Movement Disorders, 26(9), 1785-1786.
29. 30. Aydil, S., Akpinar, F. M., Akpinar, E., Beng, K., & Yagmurlu, M. F. (2019). Effectiveness of multilevel botulinum toxin A injection with integrated treatment program on spasticity reduction in non-ambulatory young children with cerebral palsy. Medical Principles and Practice, 28(4), 309-314.
30. 31. Bandholm, T., Jensen, B. R., Nielsen, L. M., Rasmussen, H., Bencke, J., Curtis, D., & et al. (2012). Neurorehabilitation with versus without resistance training after botulinum toxin treatment in children with cerebral palsy: A randomized pilot study. NeuroRehabilitation, 30(4), 277-286.
31. 32. Lannin, N. A., Novak, I., & Cusick, A. (2007). A systematic review of upper extremity casting for children and adults with central nervous system motor disorders. Clinical Rehabilitation, 21(11), 963-976.
32. 33. Stoeckmann, T. (2001). Casting for the person with spasticity. Topics in Stroke Rehabilitation, 8(1), 27-35.
33. 34. Milne, N., Miao, M., & Beattie, E. (2020). The effects of serial casting on lower limb function for children with Cerebral Palsy: a systematic review with meta-analysis. BMC Pediatrics, 20, 1-23.
34. 35. Preissner, K. S. (2002). The effects of serial casting on spasticity: A literature review. Occupational Therapy in Health Care, 14(2), 99-106.
35. 36. Hayek, S., Gershon, A., Wientroub, S., & Yizhar, Z. (2010). The effect of injections of botulinum toxin type A combined with casting on the equinus gait of children with cerebral palsy. The Journal of Bone & Joint Surgery British Volume, 92(8), 1152-1159.
36. 37. Tedroff, K., Granath, F., Forssberg, H., & Haglund‐Akerlind, Y. (2009). Long‐term effects of botulinum toxin A in children with cerebral palsy. Developmental Medicine & Child Neurology, 51(2), 120-127.
37. 38. Betancourt, J. P., Eleeh, P., Stark, S., & Jain, N. B. (2019). Impact of ankle-foot orthosis on gait efficiency in ambulatory children with cerebral palsy: a systematic review and meta-analysis. American Journal of Physical Medicine & Rehabilitation, 98(9), 759-770.
38. 39. Fess, E. E. (2002). A history of splinting: to understand the present, view the past. Journal of Hand Therapy, 15(2), 97-132.
39. 40. Garbellini, S., Robert, Y., Randall, M., Elliott, C., & Imms, C. (2018). Rationale for prescription, and effectiveness of, upper limb orthotic intervention for children with cerebral palsy: a systematic review. Disability and Rehabilitation, 40(12), 1361-1371.
40. 41. Santamato, A., Notarnicola, A., Panza, F., Ranieri, M., Micello, M. F., Manganotti, P., & et al. (2013). SBOTE study: extracorporeal shock wave therapy versus electrical stimulation after botulinum toxin type a injection for post-stroke spasticity–a prospective randomized trial. Ultrasound in Medicine & Biology, 39(2), 283-291.
41. 42. Wu, Y.-T., Chang, C.-N., Chen, Y.-M.,& Hu, G.-C. (2017). Comparison of the effect of focused and radial extracorporeal shock waves on spastic equinus in patients with stroke: a randomized controlled trial. European Journal of Physical and Rehabilitation Medicine, 54(4), 518-525.
42. 43. Emara, H. A., Al-Johani, A. H., Khaled, O. A., Ragab, W. M., & Al-Shenqiti, A. M. (2022). Effect of extracorporeal shock wave therapy on spastic equinus foot in children with unilateral cerebral palsy. Journal of Taibah University Medical Sciences, 17(5), 794-804.
43. 44. Vidal, X., Morral, A., Costa, L., & Tur, M. (2011). Radial extracorporeal shock wave therapy (rESWT) in the treatment of spasticity in cerebral palsy: a randomized, placebo-controlled clinical trial. NeuroRehabilitation, 29(4), 413-419.
44. 45. Ansari, N., Adelmanesh, F., Naghdi, S., & Tabtabaei, A. (2006). The effect of physiotherapeutic ultrasound on muscle spasticity in patients with hemiplegia: a pilot study. Electromyography and Clinical Neurophysiology, 46(4), 247.
45. 46. Ansari, N., Naghdi, S., Bagheri, H., & Ghassabi, H. (2007). Therapeutic ultrasound in the treatment of ankle plantarflexor spasticity in a unilateral stroke population: a randomized, single-blind, placebo-controlled trial. Electromyography and Clinical Neurophysiology, 47(3), 137.
46. 47. Gracies, J.-M. (2001). Physical modalities other than stretch in spastic hypertonia. Physical Medicine and Rehabilitation Clinics of North America, 12(4), 769-792.
47. 48. Sahin, N., Ugurlu, H., & Karahan, A. Y. (2011). Efficacy of therapeutic ultrasound in the treatment of spasticity: a randomized controlled study. NeuroRehabilitation, 29(1), 61-66.
48. 49. Picelli, A., Dambruoso, F., Bronzato, M., Barausse, M., Gandolfi, M., & Smania, N. (2014). Efficacy of therapeutic ultrasound and transcutaneous electrical nerve stimulation compared with botulinum toxin type A in the treatment of spastic equinus in adults with chronic stroke: a pilot randomized controlled trial. Topics in Stroke Rehabilitation, 21(sup1), S8-S16.
49. 50. Hughes, R., & Whaler, B. (1962). Influence of nerve-ending activity and of drugs on the rate of paralysis of rat diaphragm preparation by Cl. botulinum type A toxin. The Journal of Physiology, 160(2), 221.
50. 51. Intiso, D., Santamato, A., & Di Rienzo, F. (2017). Effect of electrical stimulation as an adjunct to botulinum toxin type A in the treatment of adult spasticity: a systematic review. Disability and Rehabilitation, 39(21), 2123-2133.
51. 52. Riad, J., Haglund-Akerlind, Y., & Miller, F. (2008). Power generation in children with spastic hemiplegic cerebral palsy. Gait & Posture, 27(4), 641-647.
52. 53. Damiano, D. L., Dodd, K., & Taylor, N. F. (2002). Should we be testing and training muscle strength in cerebral palsy? Developmental Medicine & Child Neurology, 44(1), 68-72.
53. 54. Williams, S. A., Reid, S., Elliott, C., Shipman, P., & Valentine, J. (2013). Muscle volume alterations in spastic muscles immediately following botulinum toxin type‐A treatment in children with cerebral palsy. Developmental Medicine & Child Neurology, 55(9), 813-820.
54. 55. Hastings‐Ison, T., & Graham, H. K. (2013). Atrophy and hypertrophy following injections of botulinum toxin in children with cerebral palsy. Developmental Medicine & Child Neurology, 55(9), 778-779.
55. 56. Williams, S. A., Elliott, C., Valentine, J., Gubbay, A., Shipman, P., & Reid, S. (2013). Combining strength training and botulinum neurotoxin intervention in children with cerebral palsy: the impact on muscle morphology and strength. Disability and Rehabilitation, 35(7), 596-605.
56. 57. Elvrum, A.-K. G., Brændvik, S. M., Sæther, R., Lamvik, T., Vereijken, B., & Roeleveld, K. (2012). Effectiveness of resistance training in combination with botulinum toxin-A on hand and arm use in children with cerebral palsy: a pre-post intervention study. BMC Pediatrics, 12, 1-9.