Randomised double blind clinical control trial comparin injections of botulinum toxin A with saline placebo to the intrinsic muscles of the thumb in children with cerebral palsy to assess improved performance in individual goal areas as measured by goal attainment scaling.

Dr Lisa Copeland0 个研究点目标入组 40 人开始时间: 2006年11月29日最近更新: 2020年1月13日

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•1. Child receiving lower limb Botulinum Toxin-A (BTX-A)injections under general anaesthetic.2.Child >10kg 3.Lower limb BTX-A dose does not exceed 14units/kg – so as to allow for safe low dose upper limb injection (total lower limb dose not to exceed 370 units).4.Child has cerebral palsy5.Child has spasticity in adductor pollicis, opponens pollicis or flexor pollicis brevis that impacts on function, hygiene or splint tolerance.6.Parent and/or child have goals for improvement of the thumb that relate to function, care and comfort, hygiene or splint tolerance.7.Parents need to be willing to commit to a home program and occupational therapy review and outcome measure appointments.8.Written informed consent has been obtained from the parent or guardian.9.For children taking oral antispasticity medications (such as Baclofen) the dose relative to body weight must be stable for a period of 3 months prior to commencement of the study.

•1.Medical contraindications to BTX-Aa.Known hypersensitivity to botulinum toxin A or the components of its formulation,b.Myasthenia gravis or Eaton-Lambert Syndrome,c.Presence of infection at injection site,2.Amyotrophic lateral sclerosis or other disorders producing a depletion of acetylcholine at the neuromuscular junction,3.Concurrent use of any drugs that interfere with neuromuscular transmission, e.g. aminoglycoside antibiotics, spectinomycin or tubocurarine-type muscle relaxants.4.Inability to commit to assessment appointments and an active home therapy program. 5.Prior surgery to thumb for spasticity or contracture management.6.Previous BTX-A treatment to the upper limb within the last 6 months.7.Oral anti-spasticity medication (e.g. baclofen) unless the dose has been stable relative to weight for at least 3 months.8.Athetosis9.Where the child uses the spasticity in the thumb for function.10.Where the child has spasticity in their long finger flexors that restricts adequate finger extension to achieve functional grasp.

发起方

Dr Lisa Copeland