Cochrane · systematic review · CD003469
Botulinum toxin A as an adjunct to treatment in the management of the upper limb in children with spastic cerebral palsy (UPDATE)
Hoare, BJ, Wallen, MA, Imms, C, et al. · Cochrane Database of Systematic Reviews · 2010 · Cochrane Library
Movement DisordersAMSTAR 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
42
current version
GRADE rated
36
No studies
0
Included studies
NR
No studies 0 · 0%Ungraded 6 · 14.3%Very low 0 · 0%Low 0 · 0%Moderate 19 · 45.2%High 17 · 40.5%
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 Placebo/no treatment for children with cerebral palsy
Population: children with cerebral palsy
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Elbow flexor spasticity modified Tardieu scale. Scale from: 0 to 180. BoNT‐A vs Placebo/no treatment | no estimate extracted | 1 study · 34 participants | Moderate |
Wrist flexor spasticity modified Tardieu scale. Scale from: 0 to 90. BoNT‐A vs Placebo/no treatment | no estimate extracted | 1 study · 34 participants | Moderate |
Quality of movement (18 mths ‐ 8yrs) Quality of Upper Extremity Skills Test. Scale from: 0 to 100. BoNT‐A vs Placebo/no treatment | no estimate extracted | 1 study · 13 participants | Moderate |
Quality of movement (5 yrs ‐ 15yrs) The Melbourne Assessment. Scale from: 0 to 100. BoNT‐A vs Placebo/no treatment | no estimate extracted | 1 study · 21 participants | Moderate |
Goal attainment Goal Attainment Scaling3. Scale from: 20 to 80. BoNT‐A vs Placebo/no treatment | no estimate extracted | 1 study · 32 participants | Moderate |
Occupational performance ‐ performance Canadian Occupational Performance Measure. Scale from: 0 to 10. BoNT‐A vs Placebo/no treatment | no estimate extracted | 1 study · 34 participants | High |
Occuptional performance ‐ satisfaction Canadian Occupational Performance Measure. Scale from: 0 to 10. BoNT‐A vs Placebo/no treatment | no estimate extracted | 1 study · 34 participants | High |
BoNT‐A/OT compared to OT only for children with cerebral palsy
Population: children with cerebral palsy
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Elbow flexor spasticity modified Tardieu scale. Scale from: 0 to 180. BoNT‐A/OT vs OT only | no estimate extracted | 1 study · 36 participants | High |
Wrist flexor spasticity modified Tardieu scale. Scale from: 0 to 90. BoNT‐A/OT vs OT only | no estimate extracted | 1 study · 36 participants | High |
Quality of movement (18 mths ‐ 8yrs) Quality of Upper Extremity Skills Test. Scale from: 0 to 100. BoNT‐A/OT vs OT only | no estimate extracted | 3 studies · 84 participants | High |
Quality of movement (5 yrs ‐ 15yrs) The Melbourne Assessment. Scale from: 0 to 100. BoNT‐A/OT vs OT only | no estimate extracted | 3 studies · 69 participants | High |
Goal attainment Goal Attainment Scaling2. Scale from: 20 to 80. BoNT‐A/OT vs OT only | no estimate extracted | 4 studies · 152 participants | High |
Occupational performance ‐ performance Canadian Occupational Performance Measure. Scale from: 0 to 10. BoNT‐A/OT vs OT only | no estimate extracted | 3 studies · 109 participants | High |
Occupational performance ‐ satisfaction Canadian Occupational Performance Measure. Scale from: 0 to 100. BoNT‐A/OT vs OT only | no estimate extracted | 3 studies · 109 participants | High |
BoNT‐A/OT compared to BoNT‐A only for children with cerebral palsy
Population: patients with children with cerebral palsy
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Elbow flexors spasticity modified Tardieu scale. Scale from: 0 to 180. BoNT‐A/OT vs BoNT‐A only | no estimate extracted | 1 study · 39 participants | Moderate |
Wrist flexor spasticity modified Tardieu scale. Scale from: 0 to 90. BoNT‐A/OT vs BoNT‐A only | no estimate extracted | 1 study · 39 participants | High |
Quality of movement (18 mths ‐ 8yrs) Quality of Upper Extremity Skills Test. Scale from: 0 to 100. BoNT‐A/OT vs BoNT‐A only | no estimate extracted | 1 study · 14 participants | Moderate |
Quality of movement (5 yrs ‐ 15yrs) The Melbourne Assessment. Scale from: 0 to 100. BoNT‐A/OT vs BoNT‐A only | no estimate extracted | 1 study · 22 participants | High |
Goal attainment Goal Attainment Scaling3. Scale from: 20 to 80. BoNT‐A/OT vs BoNT‐A only | no estimate extracted | 1 study · 39 participants | High |
Occupational performance ‐ performance Canadian Occupational Performance Measure. Scale from: 0 to 10. BoNT‐A/OT vs BoNT‐A only | no estimate extracted | 1 study · 39 participants | Moderate |
Occupational performance ‐ satisfaction Canadian Occupational Performance Measure. Scale from: 0 to 10. BoNT‐A/OT vs BoNT‐A only | no estimate extracted | 1 study · 39 participants | Moderate |
BoNT‐A/OT compared to Placebo/no treatment for children with cerebral palsy
Population: children with cerebral palsy
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Elbow flexor spasticity modified Tardieu scale. Scale from: 0 to 100. BoNT‐A/OT vs Placebo/no treatment | no estimate extracted | 1 study · 35 participants | Moderate |
Wrist flexor spasticity modified Tardieu scale. Scale from: 0 to 90. BoNT‐A/OT vs Placebo/no treatment | no estimate extracted | 1 study · 35 participants | High |
Quality of movement (18 mths ‐ 8yrs) Quality of Upper Extremity Skills Test. Scale from: 0 to 100. BoNT‐A/OT vs Placebo/no treatment | no estimate extracted | 1 study · 13 participants | Moderate |
Quality of movement (5 yrs ‐ 15yrs) The Melbourne Assessment. Scale from: 0 to 100. BoNT‐A/OT vs Placebo/no treatment | no estimate extracted | 1 study · 19 participants | Moderate |
Goal attainment Goal Attainment Scaling3. Scale from: 20 to 80. BoNT‐A/OT vs Placebo/no treatment | no estimate extracted | 1 study · 33 participants | High |
Occupational performance ‐ performance Canadian Occupational Performance Measure. Scale from: 0 to 10. BoNT‐A/OT vs Placebo/no treatment | no estimate extracted | 1 study · 35 participants | High |
Occupational performance ‐ satisfaction Canadian Occupational Performance Measure. Scale from: 0 to 10. BoNT‐A/OT vs Placebo/no treatment | no estimate extracted | 1 study · 35 participants | High |
BoNT‐A only compared to OT only for children with cerebral palsy
Population: children with cerebral palsy
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Elbow flexor spasticity modified Tardieu scale. Scale from: 0 to 180. BoNT‐A only vs OT only | no estimate extracted | 1 study · 35 participants | High |
Wrist flexor spasticity modified Tardieu scale. Scale from: 0 to 90. BoNT‐A only vs OT only | no estimate extracted | 1 study · 35 participants | Moderate |
Quality of movement (18 mths ‐ 8yrs) QUEST. Scale from: 0 to 100. BoNT‐A only vs OT only | no estimate extracted | 1 study · 13 participants | Moderate |
Quality of movement (5 yrs ‐ 15yrs) The Melbourne Assessment. Scale from: 0 to 100. BoNT‐A only vs OT only | no estimate extracted | 1 study · 21 participants | Moderate |
Goal attainment Goal attainment scaling3. Scale from: 20 to 80. BoNT‐A only vs OT only | no estimate extracted | 1 study · 36 participants | Moderate |
Occupational performance ‐ performance Canadian Occupational Performance Measure. Scale from: 0 to 10. BoNT‐A only vs OT only | no estimate extracted | 1 study · 36 participants | Moderate |
Occupational performance ‐ satisfaction Canadian Occupational Performance Measure. Scale from: 0 to 10. BoNT‐A only vs OT only | no estimate extracted | 1 study · 36 participants | Moderate |
High dose BoNT‐A compared to Low dose BoNT‐A in children with cerebral palsy
Population: children with cerebral palsy
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Elbow flexor spasticity High dose BoNT‐A vs Low dose BoNT‐A | no estimate extracted | 0 studies · 1 participants | Ungraded |
Wrist flexor spasticity High dose BoNT‐A vs Low dose BoNT‐A | no estimate extracted | 0 studies · 1 participants | Ungraded |
Quality of movement (18 mths ‐ 8yrs) Quality of Upper Extremity Skills Test. Scale from: 0 to 100. High dose BoNT‐A vs Low dose BoNT‐A | no estimate extracted | 1 study · 39 participants | Moderate |
Goal attainment High dose BoNT‐A vs Low dose BoNT‐A | no estimate extracted | 0 studies · 1 participants | Ungraded |
Quality of movement (5 yrs to 15 yrs) High dose BoNT‐A vs Low dose BoNT‐A | no estimate extracted | 0 studies · 1 participants | Ungraded |
Occupational performance ‐ performance High dose BoNT‐A vs Low dose BoNT‐A | no estimate extracted | 0 studies · 1 participants | Ungraded |
Occupational performance ‐ satisfaction High dose BoNT‐A vs Low dose BoNT‐A | no estimate extracted | 0 studies · 1 participants | Ungraded |