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Investigation of the functional benefit and the peripheral and central pathway changes that occur with strength specific training for upper limb function with and without Botulinum Toxin A in children with spastic hemiplegic cerebral palsy: A randomised c
A series of papers are being prepared to publish the results of research into optimum method of administration and the efficacy of Botulinum Neurotoxin type A (BoNTA) and physical therapy in improving upper limb function in children with hemiplegic cerebral palsy. BoNTA is a drug that is injected into a muscle to reduce spasticity . The aim of this proposed study is to investigate the relationship between physiotherapy and spasticity management of the arm in children with CP. Primarily we will be investigating how strength training and BoNTA can help improve arm function in activities of daily living as well as trying to determine the rationale behind the effects that are being observed. This study uses outcome measures of transcranial magnetic stimulation (TMS) to map central brain changes as well as 3D motion analysis of arm reaching to quantify peripheral changes. The relationship of these to function will be determined.
There is limited understanding of the mechanism for explaining improvements in function with the use of BoNTA and physiotherapy. Understanding the mechanism of improvement will enable physiotherapy to be focussed on those aspects that can enhance intervention and maximise improvement in function.