| Summary: | 碩士 === 國立成功大學 === 物理治療研究所 === 92 ===
The purposes of the study were to 1) investigate the influence of physical therapy on the motor control in children with spastic diplegic cerebral palsy after botulinum toxin A (BTX-A) injections; 2) develop and establish a standard protocol of physical therapy program (PT) for children after BTX-A injection. Fourteen children with spastic diplegic cerebral palsy (2 to 8 years old) participated this study and were divided into three groups with three treatment conditions (immediate PT, delay PT and no PT). There were 2 month baseline phase before BTX-A injection. After BTX-A injection, PT treatment either started immediately, started delay 10 days or did not started at all. PT was provided to the children 3-4 times a week, for a total of 3 months. Outcome measures included passive range of motion (PROM), modified Ashworth scale, muscles strength and selective motor control (SMC), gait analysis and gross motor functional measure (GMFM). The outcomes were measured seven times: 3 during the baseline phase before BTX-A injection, one at 10 days after injection and then 3 at an interval of one month after injection. The results presented that there were significant decrease of muscle tone and increase in PROM in all groups (p<.05). Other functional status including SMC, gait scores and GMFM scores (p<.05) only improved in the groups of BTX-A injection plus PT intervention (immediate PT and delay PT) but not the no-PT group. The results demonstrated that PT was significant in improving the motor control in children with cerebral palsy after BTX-A injection. The content and concept of PT designed in this study could be used as a guideline for management of cerebral palsy after BTX-A injection. However, due to small sample size and a lack of randomization for grouping, the generalization of the results of the study should be cautious.
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