Longitudinal Examination of Health Outcomes Associated With Botulinum Toxin Use in Children With Cerebral Palsy


A prospective cohort study with annual follow-up was conducted on 172 children with spastic type cerebral palsy receiving botulinum toxin type A (BTX) injections for spasticity management. A mixed modeling procedure was used to identify changes in both physical functioning outcomes for the child (using the WeeFIM measure) as well as quality of life of the parent caregiver (using the Stein and Reissman Impact on the Family Scale) with increasing utilization of BTX injections. The study found that each additional BTX injection administration was associated with a 2.3% improvement in the WeeFIM compared to the average baseline score (p < .01). Similarly, the study found an improvement of 2.5% compared to baseline in the parent’s overall perception of the severity of the child’s condition with each additional BTX injection administration (p < .001). These findings suggest that BTX injections may be associated with beneficial outcomes in childhood spasticity. (Journal of Surgical Orthopaedic Advances 13(2):76–80, 2004)

Rajesh Balkrishnan, PhD, Janeen C. Manuel, PhD, Beth P. Smith, PhD,
Fabian T. Camacho, MS, and L. Andrew Koman, MD