Long lasting benefits following the combination of static night upper extremity splinting with botulinum toxin A injections in cerebral palsy children

Eur J Phys Rehabil Med. 2009 Dec;45(4):501-6. Epub 2009 Jan 21.


Aim: Botulinum toxin A injections and orthotics have been used to manage upper extremity spasticity in hemiplegic children. The authors performed a study to evaluate the necessity and effectiveness of a static night splint following outpatient botulinum toxin A treatment in children with upper limb spastic cerebral palsy.

Methods: Twenty children with upper limb spastic cerebral palsy were treated with botulinum toxin A injections. A static night splint was applied in half of them. Objective assessment of upper limb function was performed at baseline, at 2 and 6 months after botulinum toxin A injection using the Quality of Upper Extremity Skills Test.

Results: After botulinum toxin A treatment, both groups showed an improvement on their previous functional level of the injected upper extremity. At 2 months, children in group A showed a 15.4% improvement, whereas children in group B improved by 12.2% from baseline; these were not statistically significant (P=0.326). At 6 months, group A still maintained a 15.9% improvement in function compared to group B which differed only by 4.2% from prebotulinum toxin A baseline; these differences were statistically significant (P=0.000). Complications related to the botulinum toxin A injection were not observed. The static

Conclusions: Static night splinting following botulinum toxin A injections has shown a definite treatment effect in reducing spasticity and improving function in children with upper limb spastic cerebral palsy.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Botulinum Toxins, Type A / therapeutic use*
  • Cerebral Palsy / complications*
  • Cerebral Palsy / physiopathology
  • Cerebral Palsy / therapy
  • Child
  • Child, Preschool
  • Combined Modality Therapy
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Muscle Spasticity / etiology
  • Muscle Spasticity / physiopathology
  • Muscle Spasticity / therapy*
  • Neuromuscular Agents / therapeutic use*
  • Prospective Studies
  • Recovery of Function
  • Splints*
  • Time Factors
  • Treatment Outcome
  • Upper Extremity*


  • Neuromuscular Agents
  • Botulinum Toxins, Type A