HAND REHABILITATION WITH TENDON TRANSFER SURGERY AND WITH BOTULINUM TOXIN INJECTION IN HEMIPLEGIC CHILDREN: SIMILARITIES AND DIFFERENCES

Abstract

The purpose of this study is to investigate the effect of two treatment strategies hand rehabilitation including tendon transfer surgery and hand rehabilitation including botulinum toxin type A (BTX-A) injection in hemiplegic children. This study is alsn conducted to clarifY the similarities and differences between two treatment strategies. Two groups of hemiplegic children -ten child in each group- participated in this study. The first group of children (group A) aged from eight to eleven years old anu were treated by hand rehabilitation program included tendon transfer surr;ery. The second group of children (group B) aged from four to six and half years old and were treated by hand rehabilitation program including BTX-A injection Evaluation of wrist extension, forearm supination, hand grip strength and fine motor skills were studied in two patient groups before starting the treatment after three months and after six months of treatment The results of the present study shows a highly significant• improvement in all .measuring parameters for the two groups except for a highly significant reduction in hand grip strength in the first group which wanoticed after three months of treatment. In addition, considerable differences between the two• groups were demonstrated in relation to age, pretreatment status of children and the level of improvement at the end of a rehabilitation program. In conclusion, the results of this study confirmed that a multidisciplinary approach is essential in the management of CP children.