Thumb in palm deformity frequently seen in children with spastic cerebral palsy The consequences can be burdensome and lifelong Impairs the ability to use the thumb Limits hand function and range of motion Management of thumb in palm deformity is multi-disciplinary Thumb in palm deformity, hand function, spastic cerebral palsy, Botulinum toxin type A, hand splint, spasticity, range of motion
Conditions
Interventions
1. Medication is Botulinum toxin type A(Botox)
2.Preparations dilute 100 U of BTX-A with 2 mL(50 U/ml) of preservative-free 0.9% sodium chloride for injection.
3.Local anesthesia with EMLA ( lidocain
Experimental Drug,Experimental Device,Active Comparator Procedure/Surgery
Botulinum toxin type A,Hand splint,standard occupational Therapy
Sponsors
Ratchadapisek Research Funds(For graduate students, residents, fellows)
Eligibility
Sex/Gender
All
Age
3 Years to 8 Years
Inclusion criteria
Inclusion criteria: 1.Spastic CP with Thumb in palm deformity and impaired with hand functional use and/or limiting activities of daily living, 2.Inform consent and assent signed, 3.Between 3 and 8 years of age, 4. Modified ashworth scale (MAS) of adductor pollicis = 1-3, 5.Can follow at lease 1 step command
Exclusion criteria
Exclusion criteria: 1.Unstable medical or neurological condition, 2.Previous hand/arm surgery, 3.BoNT-A injections within the last 6 month, 4.Fixed contractures of upper limb, 5.Joint instability, 6.Can not wear a splint, 7.Contraindication of BoNT-A, lidocaine and Prilociane
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Hand function at 4 week and 12 week after start the intervention Quality of upper extremity skills test-Grasp domain | — |
Secondary
| Measure | Time frame |
|---|---|
| Spasticity at 4 week and 12 week after start the intervention Modified Ashworth Scale,Range of motion at 4 week and 12 week after start the intervention Range of motion scale,Satisfaction at 4 week and 12 week after start the intervention Satisfaction scale | — |
Countries
Thailand
Contacts
Public ContactSuthima Srifa
Faculty of Medicine, Chulalongkorn University
Outcome results
None listed