Effect of Botulinum Toxin Type A Associated With Physical Therapy on Children With Spastic Cerebral Palsy

Botulinum Toxin type A The intervention with BoNT-A (Dysport®, Ipsen Biopharmaceutical, USA) was performed in the gastrocnemius and soleus muscles, bilaterally for diplegic children and unilaterally for hemiplegic children.

"Physiotherapeutic intervention was performed twice a week, with duration of one hour per session for 4 weeks. To maintain standardization of treatment, physiotherapists received a booklet with instructions on what treatment they should do.~The intervention protocol consisted of:~* Passive stretching of lower limbs,~* Stretching associated with the functionality of the plantar flexor muscles, knee flexors, adductors and hip flexors;~* Strengthening of the antagonist muscles with the application of BoNT-A;~* Static and dynamic balance training;~* Up and down stairs;~* Functional walking training, prioritizing the initial contact of the heel and active and passive dorsiflexion."