Effect of physiotherapeutic intervention on the gait after the application of botulinum toxin in children with cerebral palsy: Systematic review

Introduction: Cerebral palsy is a group of movement and posture development disorders. 90% of this population has gait impairment, often due to the presence of spasticity. Anumber of studies emphasize the importance of combined physical therapy with botulinum toxin Atreatment. However, no consensus can be reached concerning the content of the physiotherapy program after treatment with botulinum toxin A. The purpose of the present study was to investigate, through a systematic review of the literature, the effects of physiotherapeutic intervention on gait after botulinum toxin application in children with cerebral palsy. Evidence Acquisition: PubMed, Scielo, Cochrane Library, OTseeker, and PEDro databases were searched for randomized trial published between January 2000 and January 2017. Evidence Synthesis: Sixty-eight articles were identified, four of which met the eligibility criteria and were selected for the present systematic review. Atable was created showing the main characteristics of the studies (groups, inclusion criteria, dosage, injection site, physiotherapeutic intervention, evaluation and outcomes). Conclusions: This study offers a view on the increase in the therapeutic effectiveness of botulinum toxin Aon the lower limbs when used in conjunction with a physiotherapeutic intervention, with improvements in mobility, gait pattern, range of motion and spasticity, which are maintained after the end of the physical therapy protocol. The use of botulinum toxin Aon the lower limbs when used in conjunction with a physiotherapeutic intervention, can improve muscle tone, allowing a combined treatment and intended to provide improvement of motor ability and functional skills, and potentially, delay the need for surgery.