Cochrane · systematic review · CD001408
Botulinum toxin type A in the treatment of lower limb spasticity in children with cerebral palsy
Blumetti, FC, Belloti, JC, Tamaoki, MJS, et al. · Cochrane Database of Systematic Reviews · 2019 · Cochrane Library
Developmental, Psychosocial and Learning ProblemsAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
70
current version
GRADE rated
47
No studies
23
Included studies
NR
No studies 23 · 32.9%Ungraded 0 · 0%Very low 15 · 21.4%Low 9 · 12.9%Moderate 23 · 32.9%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
BoNT‐A compared to usual care or physiotherapy in the treatment of lower limb spasticity in children with cerebral palsy: short‐term results
Population: children with CP
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Instrumented gait analysis (kinematics) (not measured) BoNT‐A vs usual care or physiotherapy | no estimate extracted | NR | No studies |
Observational gait analysis (not measured) BoNT‐A vs usual care or physiotherapy | no estimate extracted | NR | No studies |
Function BoNT‐A vs usual care or physiotherapy | no estimate extracted | 2 studies · 123 participants | Very low Downgraded: imprecision |
Range of motion (passive ankle dorsiflexion) BoNT‐A vs usual care or physiotherapy | no estimate extracted | 2 studies · 186 participants | Very low Downgraded: imprecision, inconsistency |
Satisfaction (not measured) BoNT‐A vs usual care or physiotherapy | no estimate extracted | NR | No studies |
Spasticity (ankle plantarflexors) BoNT‐A vs usual care or physiotherapy | no estimate extracted | 2 studies · 186 participants | Very low Downgraded: imprecision, inconsistency |
Adverse events BoNT‐A vs usual care or physiotherapy | no estimate extracted | 5 studies · 206 participants | Very low Downgraded: imprecision, inconsistency |
BoNT‐A compared to usual care or physiotherapy in the treatment of lower limb spasticity in children with cerebral palsy: medium‐term results
Population: children with CP
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Instrumented gait analysis (kinematics) (not measured) BoNT‐A vs usual care or physiotherapy | no estimate extracted | NR | No studies |
Observational gait analysis BoNT‐A vs usual care or physiotherapy | no estimate extracted | 1 study · 40 participants | Very low Downgraded: imprecision |
Function BoNT‐A vs usual care or physiotherapy | no estimate extracted | 4 studies · 191 participants | Very low Downgraded: inconsistency |
Range of motion (passive ankle dorsiflexion) BoNT‐A vs usual care or physiotherapy | no estimate extracted | 5 studies · 272 participants | Very low Downgraded: imprecision |
Satisfaction (not measured) BoNT‐A vs usual care or physiotherapy | no estimate extracted | NR | No studies |
Spasticity (ankle plantarflexors) BoNT‐A vs usual care or physiotherapy | no estimate extracted | 3 studies · 226 participants | Very low Downgraded: imprecision |
Adverse events BoNT‐A vs usual care or physiotherapy | no estimate extracted | NR | No studies |
BoNT‐A compared to usual care or physiotherapy in the treatment of lower limb spasticity in children with cerebral palsy: long‐term results
Population: children with CP
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Instrumented gait analysis (kinematics) BoNT‐A vs usual care or physiotherapy | no estimate extracted | NR | No studies |
Observational gait analysis (not measured) BoNT‐A vs usual care or physiotherapy | no estimate extracted | NR | No studies |
Function BoNT‐A vs usual care or physiotherapy | no estimate extracted | 4 studies · 199 participants | Very low Downgraded: imprecision, inconsistency |
Range of motion (passive ankle dorsiflexion) BoNT‐A vs usual care or physiotherapy | no estimate extracted | 4 studies · 250 participants | Very low Downgraded: imprecision |
Satisfaction BoNT‐A vs usual care or physiotherapy | no estimate extracted | 1 study · 24 participants | Very low Downgraded: imprecision |
Spasticity (ankle plantarflexors) BoNT‐A vs usual care or physiotherapy | no estimate extracted | 4 studies · 258 participants | Very low Downgraded: imprecision |
Adverse events BoNT‐A vs usual care or physiotherapy | no estimate extracted | NR | No studies |
BoNT‐A compared to placebo or sham in the treatment of lower limb spasticity in children with cerebral palsy: short‐term results
Population: children with CP
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Instrumented gait analysis (peak ankle dorsiflexion in stance) BoNT‐A vs placebo or sham | no estimate extracted | 1 study · 19 participants | Moderate Downgraded: imprecision |
Observational gait analysis (improvement) BoNT‐A vs placebo or sham | RR 1.66 [1.16, 2.37] | 4 studies · 261 participants | Moderate Downgraded: imprecision |
Function BoNT‐A vs placebo or sham | no estimate extracted | 4 studies · 305 participants | Moderate Downgraded: inconsistency |
Range of motion (passive ankle dorsiflexion) BoNT‐A vs placebo or sham | no estimate extracted | 3 studies · 291 participants | Moderate Downgraded: imprecision |
Satisfaction BoNT‐A vs placebo or sham | no estimate extracted | 1 study · 41 participants | Moderate Downgraded: imprecision |
Spasticity (ankle plantarflexors) BoNT‐A vs placebo or sham | no estimate extracted | 1 study · 156 participants | Moderate Downgraded: imprecision |
Adverse events BoNT‐A vs placebo or sham | RR 1.29 [0.87, 1.93] | 12 studies · 918 participants | Moderate Downgraded: inconsistency |
BoNT‐A compared to placebo or sham in the treatment of lower limb spasticity in children with cerebral palsy: medium‐term results
Population: children with CP
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Instrumented gait analysis (kinematics) (not measured) BoNT‐A vs placebo or sham | no estimate extracted | NR | No studies |
Observational gait analysis (improvement) BoNT‐A vs placebo or sham | RR 1.9 [1.32, 2.74] | 3 studies · 248 participants | Moderate Downgraded: imprecision |
Function BoNT‐A vs placebo or sham | no estimate extracted | 5 studies · 327 participants | Moderate Downgraded: imprecision |
Range of motion (passive ankle dorsiflexion) BoNT‐A vs placebo or sham | no estimate extracted | 2 studies · 150 participants | Moderate Downgraded: imprecision |
Satisfaction BoNT‐A vs placebo or sham | no estimate extracted | 2 studies · 74 participants | Moderate Downgraded: imprecision |
Spasticity (ankle plantarflexors) BoNT‐A vs placebo or sham | no estimate extracted | 1 study · 144 participants | Moderate Downgraded: imprecision |
Adverse events BoNT‐A vs placebo or sham | no estimate extracted | NR | No studies |
BoNT‐A compared to placebo or sham in the treatment of lower limb spasticity in children with cerebral palsy: long‐term results
Population: children with CP
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Instrumented gait analysis (kinematics) (not measured) BoNT‐A vs placebo or sham | no estimate extracted | NR | No studies |
Observational gait analysis (not measured) BoNT‐A vs placebo or sham | no estimate extracted | NR | No studies |
Function BoNT‐A vs placebo or sham | no estimate extracted | 2 studies · 91 participants | Moderate Downgraded: imprecision |
Range of motion (passive ankle dorsiflexion) BoNT‐A vs placebo or sham | no estimate extracted | 1 study · 40 participants | Moderate Downgraded: imprecision |
Satisfaction BoNT‐A vs placebo or sham | no estimate extracted | 1 study · 33 participants | Moderate Downgraded: imprecision |
Spasticity (ankle plantarflexors) BoNT‐A vs placebo or sham | no estimate extracted | 1 study · 42 participants | Moderate Downgraded: imprecision |
Adverse events BoNT‐A vs placebo or sham | no estimate extracted | NR | No studies |
BoNT‐A compared to serial casting in the treatment of lower limb spasticity in children with cerebral palsy: short‐term results
Population: children with CP
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Instrumented gait analysis (peak ankle dorsiflexion in stance) (degrees) BoNT‐A vs serial casting | no estimate extracted | 1 study · 21 participants | Low Downgraded: imprecision |
Observational gait analysis BoNT‐A vs serial casting | no estimate extracted | 1 study · 18 participants | Moderate Downgraded: imprecision |
Function BoNT‐A vs serial casting | no estimate extracted | 1 study · 18 participants | Moderate Downgraded: imprecision |
Range of motion (ankle dorsiflexion) BoNT‐A vs serial casting | no estimate extracted | 1 study · 18 participants | Low Downgraded: imprecision |
Satisfaction (not measured) BoNT‐A vs serial casting | no estimate extracted | NR | No studies |
Spasticity (ankle plantarflexors) BoNT‐A vs serial casting | no estimate extracted | 1 study · 18 participants | Low Downgraded: imprecision |
Adverse events BoNT‐A vs serial casting | RR 0.59 [0.03, 11.03] | 3 studies · 64 participants | Low Downgraded: imprecision, inconsistency |
BoNT‐A compared to serial casting in the treatment of lower limb spasticity in children with cerebral palsy: medium‐term results
Population: children with CP
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Instrumented gait analysis (peak ankle dorsiflexion in stance) BoNT‐A vs serial casting | no estimate extracted | 3 studies · 61 participants | Low Downgraded: imprecision, inconsistency |
Observational gait analysis BoNT‐A vs serial casting | no estimate extracted | 1 study · 18 participants | Moderate Downgraded: imprecision |
Function BoNT‐A vs serial casting | no estimate extracted | 2 studies · 41 participants | Moderate Downgraded: imprecision |
Range of motion (passive ankle dorsiflexion) BoNT‐A vs serial casting | no estimate extracted | 3 studies · 67 participants | Low Downgraded: imprecision |
Satisfaction (not measured) BoNT‐A vs serial casting | no estimate extracted | NR | No studies |
Spasticity (ankle plantarflexors) BoNT‐A vs serial casting | no estimate extracted | 3 studies · 67 participants | Low Downgraded: imprecision |
Adverse events BoNT‐A vs serial casting | no estimate extracted | NR | No studies |
BoNT‐A compared to serial casting in the treatment of lower limb spasticity in children with cerebral palsy: long‐term results
Population: children with CP
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Instrumented gait analysis (peak ankle dorsiflexion in stance) BoNT‐A vs serial casting | no estimate extracted | 1 study · 26 participants | Moderate Downgraded: imprecision |
Observational gait analysis BoNT‐A vs serial casting | no estimate extracted | 1 study · 18 participants | Moderate Downgraded: imprecision |
Function BoNT‐A vs serial casting | no estimate extracted | 1 study · 18 participants | Moderate Downgraded: imprecision |
Range of motion (passive ankle dorsiflexion) BoNT‐A vs serial casting | no estimate extracted | 2 studies · 44 participants | Low Downgraded: imprecision |
Satisfaction (not measured) BoNT‐A vs serial casting | no estimate extracted | NR | No studies |
Spasticity (ankle plantarflexors) BoNT‐A vs serial casting | no estimate extracted | 2 studies · 44 participants | Low Downgraded: imprecision |
Adverse events BoNT‐A vs serial casting | no estimate extracted | NR | No studies |
BoNT‐A compared to orthoses in the treatment of lower limb spasticity in children with cerebral palsy: medium‐term results
Population: children with CP
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Instrumented gait analysis (not reported) BoNT‐A vs orthoses | no estimate extracted | NR | No studies |
Observational gait analysis (not reported) BoNT‐A vs orthoses | no estimate extracted | NR | No studies |
Function BoNT‐A vs orthoses | no estimate extracted | 1 study · 43 participants | Very low Downgraded: imprecision |
Range of motion (passive hip abduction) BoNT‐A vs orthoses | no estimate extracted | 1 study · 43 participants | Very low Downgraded: imprecision |
Satisfaction (not reported) BoNT‐A vs orthoses | no estimate extracted | NR | No studies |
Spasticity (hip adductors) BoNT‐A vs orthoses | no estimate extracted | 1 study · 43 participants | Very low Downgraded: imprecision |
Adverse events (not reported) BoNT‐A vs orthoses | no estimate extracted | NR | No studies |