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Combo Therapy Doesn't Benefit Children with Cerebral Palsy

Botox injections and hip abduction bracing fail to slow progressive hip displacement

THURSDAY, Jan. 10 (HealthDay News) -- In children with cerebral palsy, a combination of botulinum toxin type A injections and abduction hip bracing does not prevent progressive hip displacement, according to a study published in the Jan. 1 issue of the Journal of Bone & Joint Surgery.

H. Kerr Graham, M.D., of the Royal Children's Hospital in Victoria, Australia, and colleagues randomly assigned 90 children with bilateral cerebral palsy and "hips at risk" (a migration percentage of 10-40 percent) to receive either injections of botulinum toxin A to the adductor and hamstring muscles every six months for three years and wear a hip abduction brace for six hours per day, or receive no injections and wear no hip brace.

The researchers found that progressive hip displacement occurred in both groups and the rate of hip displacement was reduced by only 1.4 percent per year in the intervention group.

"In retrospect, the largely negative outcome of this trial is not surprising," the authors state. "The strongest association with hip displacement in children with cerebral palsy is the level of gross motor function, which is not affected by the injection of botulinum toxin A and bracing. The incidence of hip displacement in children with cerebral palsy is directly related to gross motor function and is not related to the type of movement disorder. In a recent study, children with hypotonic, spastic and dystonic cerebral palsy had similar rates of hip displacement."

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