Physical Therapy Management for Children with Cerebral Palsy after Lower Limb Botulinum Toxin Type A Injections

Botulinum toxin type A (BtA) injections to reduce spasticity for children with cerebral palsy (CP) are often accompanied by physical therapy (PT) treatment. This series of studies examined current PT strategies across Canada using survey methodology, and evaluated outcomes after PT and BtA injections using single subject methodology. Survey results revealed that variation in therapy most often related to the child’s functional level and the goals of the intervention. Outcomes after PT and BtA injection indicated that PT may help prolong the effect of BtA on range of motion, but long term functional improvements were not sustained. Care pathways for PT treatment were developed, incorporating the literature, current practice and study results. More work is needed to identify the effectiveness of specific PT treatments for children with CP after lower limb BtA injections; this work will support ongoing updates and reviews of existing care pathways.