Robotic therapy and botulinum toxin type A: a novel intervention approach for cerebral palsy

Am J Phys Med Rehabil. 2008 Dec;87(12):1022-5. doi: 10.1097/PHM.0b013e31817fb346.


The combined effects of robotic therapy and botulinum toxin type A (BTX-A) on upper-limb movement and function were studied in an 8(1/2)-yr-old child with hemiplegic cerebral palsy. Robotic therapy comprising repetitive, goal-directed reaching tasks was administered two times per week for 8 wks. Clinical measures included the Modified Ashworth Scale, the Quality of Upper Extremity Skills Test, and the Fugl-Meyer Assessment (upper-limb section). Improvements in upper-limb coordination and quality of motor performance were apparent throughout the robotic therapy trial. The observed gains are comparable with those attained from conventional occupational therapy combined with BTX-A. A parent questionnaire indicated that the amount of paretic arm use also improved during daily activities at home. This preliminary study indicates that robotic therapy may be a useful clinical tool when combined with BTX-A injections for improving upper-limb coordination and quality of motor performance in children with cerebral palsy.

Publication types

  • Case Reports
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Botulinum Toxins, Type A / therapeutic use*
  • Cerebral Palsy / rehabilitation*
  • Child
  • Combined Modality Therapy
  • Exercise Therapy / instrumentation*
  • Female
  • Hemiplegia / rehabilitation*
  • Humans
  • Neuromuscular Agents / therapeutic use*
  • Robotics*
  • Upper Extremity


  • Neuromuscular Agents
  • Botulinum Toxins, Type A