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AJPM&R Journal Club Podcast: Effect of Onabotulinum Toxin A on Passive Muscle Stiffness in Children with Cerebral Palsy
Joline Brandenburg
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This Journal Club Podcast is brought to you by Association of Academic Physiatrists and features research published in the American Journal of Physical Medicine & Rehabilitation.


Drs. Eric Wisotzky and Lindsey Migliore interview Dr. Joline Brandenburg, who is board certified in Physical Medicine and Rehabilitation and Pediatric Rehabilitation Medicine, regarding her study Quantifying Effect of Onabotulinum Toxin A on Passive Muscle Stiffness in Children with Cerebral Palsy Using Ultrasound Shear Wave Elastography. Dr. Brandenburg holds the academic rank of Assistant Professor in both Physical Medicine and Rehabilitation and Pediatric and Adolescent Medicine at the Mayo Clinic College of Medicine.

Objective: A pilot study was conducted to longitudinally quantify effect of onabotulinum toxin A (BoNT-A) on passive muscle properties in children with cerebral palsy using ultrasound shear wave elastography.

Design: This was a prospective longitudinal cohort study.

Results: Between 1 and 3 mos post-BoNT-A, a significant improvement in the shear modulus of the lateral gastrocnemius was found at 10-degrees plantar flexion (PF) (−7.57 [−10.98, −5.07], P = 0.02) and 0-degrees PF (−14.74 [−18.21, −9.38], P = 0.03). There was a notable, but nonsignificant, difference in shear modulus at 20-degrees PF, 10-degrees PF, and 0-degrees PF between pre-BoNT-A and 1 mo post-BoNT-A. Pre-BoNT-A shear modulus was not significantly different from 3 mos post-BoNT-A at all foot positions. No significant differences in ankle passive range of motion or spasticity were found.

Conclusion: Despite no significant change in ankle range of motion or spasticity, shear wave elastography was able to detect a difference in lateral gastrocnemius passive muscle properties in children with cerebral palsy after BoNT-A injections. The difference in passive muscle properties resolved by 3 mos post-BoNT-A.

Keywords
Cerebral Palsy; Ultrasound Imaging; Elastography; Muscles
Summary
Availability: On-Demand
Cost: FREE
Credit Offered: No Credit Offered
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