{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T21:29:47Z","timestamp":1790026187208,"version":"4.0.1"},"reference-count":25,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2015,11,20]],"date-time":"2015-11-20T00:00:00Z","timestamp":1447977600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Develop Med Child Neuro"],"published-print":{"date-parts":[[2016,7]]},"abstract":"<jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>\n                      We compared two botulinum toxin A (Bo\n                      <jats:styled-content style=\"fixed-case\">NT<\/jats:styled-content>\n                      \u2010A) injection frequency regimens, 12\u2010monthly versus 4\u2010monthly, for spastic equinus in a randomized clinical trial. The primary outcome measure was passive ankle dorsiflexion.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>\n                      Forty\u2010two ambulant children with spastic equinus, secondary to cerebral palsy (23 males and 19 females; mean age 3y 6mo,\n                      <jats:styled-content style=\"fixed-case\">SD<\/jats:styled-content>\n                      13mo;\n                      <jats:styled-content style=\"fixed-case\">GMFCS<\/jats:styled-content>\n                      levels I [\n                      <jats:italic>n=<\/jats:italic>\n                      20],\n                      <jats:styled-content style=\"fixed-case\">II<\/jats:styled-content>\n                      [\n                      <jats:italic>n<\/jats:italic>\n                      =19],\n                      <jats:styled-content style=\"fixed-case\">III<\/jats:styled-content>\n                      [\n                      <jats:italic>n<\/jats:italic>\n                      =3]) were randomized to receive either 12\u2010monthly or 4\u2010monthly Bo\n                      <jats:styled-content style=\"fixed-case\">NT<\/jats:styled-content>\n                      \u2010A injections to the calf, over a 26\u2010month period. Twenty\u2010one children had spastic hemiplegia, 21 children had spastic diplegia. A fixed 6U\/kg dose of Botox was injected into the gastrocnemius muscle of both limbs in children with diplegia and the gastrocsoleus of the affected limb in children with hemiplegia, under mask anaesthesia.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Forty\u2010two children entered the trial with 21 participants randomized to each group. There were three withdrawals and two children received serial casting midway through the trial. There was no significant difference in passive dorsiflexion between 12\u2010monthly and 4\u2010monthly regimens (\n                      <jats:italic>p<\/jats:italic>\n                      =0.41). There were also no significant between group differences on secondary outcome measures. There were no serious adverse events \u2013 the rate was 1.2 adverse events per child per year in the 12\u2010monthly group and 2.2 adverse events per child per year in the 4\u2010monthly group. Subgroup analysis revealed a significant difference in passive dorsiflexion between children with hemiplegia and diplegia (\n                      <jats:italic>p<\/jats:italic>\n                      =0.01).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interpretation<\/jats:title>\n                    <jats:p>\n                      There was no significant difference between 12\u2010monthly and 4\u2010monthly injection regimens on passive dorsiflexion or secondary outcome measures. Bo\n                      <jats:styled-content style=\"fixed-case\">NT<\/jats:styled-content>\n                      \u2010A injections for spastic equinus may be recommended on a 12\u2010monthly basis.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/dmcn.12962","type":"journal-article","created":{"date-parts":[[2015,11,20]],"date-time":"2015-11-20T23:49:02Z","timestamp":1448063342000},"page":"750-757","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":41,"title":["Injection frequency of botulinum toxin A for spastic equinus: a randomized clinical trial"],"prefix":"10.1111","volume":"58","author":[{"given":"Tandy","family":"Hastings\u2010Ison","sequence":"first","affiliation":[{"name":"Murdoch Childrens Research Institute Royal Children's Hospital Parkville Vic. Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine","family":"Blackburn","sequence":"additional","affiliation":[{"name":"Murdoch Childrens Research Institute Royal Children's Hospital Parkville Vic. Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barry","family":"Rawicki","sequence":"additional","affiliation":[{"name":"Victorian Paediatric Rehabilitation Service Monash Children's Hospital Clayton Vic. Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Fahey","sequence":"additional","affiliation":[{"name":"Department of Paediatrics Faculty of Medicine, Nursing and Health Sciences Monash University Melbourne Vic. Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pam","family":"Simpson","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Preventive Medicine Monash University Melbourne Vic. Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Baker","sequence":"additional","affiliation":[{"name":"School of Healthcare Science University of Salford Salford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kerr","family":"Graham","sequence":"additional","affiliation":[{"name":"NHMRC\u2010Funded Centre of Research Excellence in Cerebral Palsy Melbourne Vic. 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