Spasticity is a very common symptom that affects around 66% of individuals with CP (Nuttin, Ivanhoe, Albright, Dimitrije & Saltuari, 1999). In the 1970s drugs were slowly becoming a treatment option for spasticity, two such drugs were baclofen and diazepam. Baclofen is a GABA agonist which means it inhibits calcium uptake causing the release of excitatory neurotransmitters (Nuttin et al,. 1999). Diazepam is an agonist of the GABAA receptor which causes the opening of a channel and allows a chloride influx (Cartlidge et al,. 1974). Due to the differences between baclofen and diazepam there was a study done to compare the two drugs. It was noted that diazepam may be more effective than baclofen but it produced side effects (Cartlidge, Hudgson …show more content…
They evaluated about 40,000 infants to see if they had any predetermined symptoms associated with CP. They found that children had at least on of the following symptoms: birth weight was less than 2,000 grams and prolonged crying for more than one day (Nelson & Ellenberg, 1979). Further they found that diminished activity, apgar score of 3 or less, thermal instability, gavage feeding or hypo/hypertonia were (Nelson & Ellenberg, 1979).
A popular surgical treatment was selective posterior rhizotomy (SPR) which is where a lumbar laminectomy is done with the stimulation of rootlets in the spine from L2 to S2 (Peacock, Arens, and Berman 1987). Another study identified 25 children with spastic CP before and after the surgical treatment to assess the effects of SPR. The results showed a reduction in muscle tone, range of movement and motor function (Peacock & Staudt, 1991). It also showed improvements in gross motor skills (Peacock & Staudt, …show more content…
the efficacy as safety of the administration of intramuscular botulinum toxin A (BoNT-A) was examined. Botulinium toxin was known to reduce spasticity and improve comfort and ease of care in nonambulent children with cerebral palsy (Copeland et al., 2014). Nonambulent children with CP are seen as levels four and five on the GMFCS scale. According to the scale this means these children require an ample amount of assistance for daily activities. This study took 42 nonambulent children with CP and randomly placed them into the sham procedure group or the group that received an intramuscular BoNT-A injection. Clinically BoNT-A was used with other interventions for rehabilitation (Copeland et al., 2014). For the surgery the injections were given using ultra sound or muscle stimulation for guidance to site of injection needle. After the injection, weather it was sham or real, each participants received OT or PT within 2 weeks.
Two different measure types that was were used in this study were the Canadian Occupation al Performance Measure (COMP) and Caregiver Priorities and Child Health Index of Life with Disabilities (CHCHILD). COMP reports on satisfaction of self-care, leisure and productivity (Copeland et al., 2014). The CPCHILD is a measure from the caregiver which reports priorities of health status. This measure has been developed specifically for children with CP with GMFCS levels from three to five (Copeland et al.,