Value of botulinum toxin injections preceding a comprehensive rehabilitation period for children with spastic cerebral palsy: A cost-effectiveness study
Fabienne Schasfoort, Annet Dallmeijer, Robert Pangalila, Coriene Catsman, Henk Stam, Jules Becher, Ewout Steyerberg, Suzanne Polinder, Johannes Bussmann
Rehabilitation Medicine, Erasmus MC, NL-3000 CA Rotterdam, The Netherlands. E-mail: f.schasfoort@erasmusmc.nl
DOI: 10.2340/16501977-2267
Lay Abstract
For children with spastic cerebral palsy, botulinum toxin injections are often part of a combined treatment package, that usually also includes a physiotherapy period and additional casting or orthoses. It is known that such a combined package is effective, but up to now the botulinum toxin contribution to the total treatment effect is unclear. Our study is the first to specifically study the added value of the botulinum toxin injections for improving gross motor function, physical activity levels and/or quality of life in spastic cerebral palsy. In a group of 65 children aged 4 to 12 years, we found no differences in effect between the group that received the package with injections and the group that did not. Therefore, prescription and use of botulinum toxin for these treatment goals needs critical reconsideration.
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