Randomised controlled trial of the impact of the first intramuscular Botulinum toxin A (BoNT-A) on muscle structure and function in children with CP

Chief Investigators

Dr Lee Barber, Prof Roslyn Boyd, Dr Glen Lichtwark (QLD), Prof Catherine Elliott (WA), Prof Kerr Graham (VIC)

About the study

Background: Botulinum toxin type-A (BoNT-A) is used to reduce spasticity in children with CP, however it can reduce muscle growth and strength. This study used innovative ultrasound methods (2D/3D) to examine the impact of BoNT-A on calf muscle growth/structure in children with CP naïve to BoNT-A.

Design: Randomised, wait-list controlled, assessor-blinded multi-site trial of BoNT-A of 50 infants with spastic type CP aged 2- 5years (25/25 Rx, Control) and 25 age matched TDC.

Methods: Primary: muscle cross sectional area. Secondary: lower limb anaerobic power, habitual physical activity and participation to determine outcomes.

Please see our Study Flyer for further information.

Recruitment criteria

We investigated the shape, size and structure of the calf muscles in children with and without cerebral palsy, using 3D ultrasound to observe muscle growth.

If you have a child with cerebral palsy between the ages of 2 and 5 years, you both could help us.

Publications

• Read, F. A., Boyd, R. N., & Barber, L. A. (2017). Longitudinal assessment of gait quality in children with bilateral cerebral palsy following repeated lower limb intramuscular Botulinum toxin-A injections. Research in Developmental Disabilities, 68, 35–41. https://doi.org/10.1016/j.ridd.2017.07.002

• Barber, L., Hastings-Ison, T., Baker, R., Kerr Graham, H., Barrett, R., & Lichtwark, G. (2013). The effects of botulinum toxin injection frequency on calf muscle growth in young children with spastic cerebral palsy: A 12-month prospective study. Journal of Children’s Orthopaedics, 7(5), 425–433. https://doi.org/10.1007/s11832-013-0503-x