{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T07:13:10Z","timestamp":1791357190737,"version":"4.3.1"},"reference-count":30,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2007,5,1]],"date-time":"2007-05-01T00:00:00Z","timestamp":1177977600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Develop Med Child Neuro"],"published-print":{"date-parts":[[2007,5]]},"abstract":"<jats:p>This study compared the effects of low and high doses of botulinum toxin A (BTX\u2010A) to improve upper extremity function. Thirty\u2010nine children (22 males, 17 females) with a mean age of 6 years 2 months (SD 2y 9mo) diagnosed with spastic hemiplegia or triplegia were enrolled into this double\u2010blind, randomized controlled trial. The high\u2010dose group received BTX\u2010A in the following doses: biceps 2U\/kg, brachioradialis 1.5U\/kg, common flexor origin 3U\/kg, pronator teres 1.5U\/kg, and adductor\/opponens pollicis 0.6U\/kg to a maximum of 20U. The low\u2010dose group received 50% of this dosage. Outcomes were measured at baseline and at 1 and 3 months after injection, and results were analyzed with a repeated\u2010measures analysis of variance. There was no significant difference between the low\u2010dose and high\u2010dose groups in upper extremity function over the 3\u2010month period as measured by the Quality of Upper Extremity Skills Test (<jats:italic>F<\/jats:italic>[1,37]=0.18, <jats:italic>p<\/jats:italic>=0.68). There was no difference between the groups in the Pediatric Evaluation of Disability Inventory Self Care Domain (<jats:italic>F<\/jats:italic>[1,37]=0.05, <jats:italic>p<\/jats:italic>=0.83). Although grip strength decreased over the 3\u2010month period, there was no difference between groups (<jats:italic>F<\/jats:italic>[1,32]=0.45, <jats:italic>p<\/jats:italic>=0.51). These findings indicate that there is no difference in hand and arm function between a low dose and a high dose of BTX\u2010A at 1 and 3 months after injection. This information can be used to guide dosage of BTX\u2010A for the management of upper extremity spasticity in children.<\/jats:p>","DOI":"10.1111\/j.1469-8749.2007.00331.x","type":"journal-article","created":{"date-parts":[[2009,6,23]],"date-time":"2009-06-23T07:38:00Z","timestamp":1245742680000},"page":"331-337","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":60,"title":["A randomized controlled trial comparing botulinum toxin A dosage in the upper extremity of children with spasticity"],"prefix":"10.1111","volume":"49","author":[{"given":"Anne","family":"Kawamura","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kent","family":"Campbell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophie","family":"Lam\u2010Damji","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Darcy","family":"Fehlings","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2007,5]]},"reference":[{"key":"e_1_2_2_2_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1468-1331.2001.00034.x"},{"key":"e_1_2_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/0007-1226(93)90203-N"},{"key":"e_1_2_2_4_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-8749.1997.tb07408.x"},{"key":"e_1_2_2_5_2","doi-asserted-by":"publisher","DOI":"10.1067\/mpd.2000.108393"},{"key":"e_1_2_2_6_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1468-1331.2001.00047.x"},{"key":"e_1_2_2_7_2","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-4598(1997)6 <181::AID-MUS13>3.0.CO;2-9"},{"key":"e_1_2_2_8_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-2000-15289"},{"key":"e_1_2_2_9_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-2007-979765"},{"key":"e_1_2_2_10_2","doi-asserted-by":"publisher","DOI":"10.1097\/00002060-200001000-00012"},{"key":"e_1_2_2_11_2","volume-title":"Quality of Upper Extremity Skills Test","author":"DeMatteo C","year":"1992"},{"key":"e_1_2_2_12_2","volume-title":"Pediatric Evaluation of Disability Inventory","author":"Haley SM","year":"1992"},{"key":"e_1_2_2_13_2","doi-asserted-by":"publisher","DOI":"10.1300\/J006v13n04_04"},{"key":"e_1_2_2_14_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-8749.1988.tb04805.x"},{"key":"e_1_2_2_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/0021-9681(81)90073-4"},{"key":"e_1_2_2_16_2","doi-asserted-by":"publisher","DOI":"10.1093\/ptj\/67.2.206"},{"key":"e_1_2_2_17_2","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1300\/J006v19n02_03","article-title":"Goal attainment scaling: its use in evaluating pediatric therapy programs","volume":"19","author":"King GA","year":"1999","journal-title":"Phys Occup Ther Pediatr"},{"key":"e_1_2_2_18_2","first-page":"341","volume-title":"Evaluation of Human Service Programs","author":"Kiresuk TJ","year":"1978"},{"key":"e_1_2_2_19_2","volume-title":"Goal Attainment Scaling: Applications, Theory, and Measurement","author":"Kiresuk TJ","year":"1994"},{"key":"e_1_2_2_20_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-8749.1991.tb14897.x"},{"key":"e_1_2_2_21_2","doi-asserted-by":"publisher","DOI":"10.1017\/S0012162203000380"},{"key":"e_1_2_2_22_2","doi-asserted-by":"publisher","DOI":"10.1002\/mus.880160913"},{"key":"e_1_2_2_23_2","doi-asserted-by":"publisher","DOI":"10.1097\/00002060-200205000-00007"},{"key":"e_1_2_2_24_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.PHM.0000137314.38806.95"},{"key":"e_1_2_2_25_2","volume-title":"The Innervation of Muscle: A Biopsy Study","author":"Coers C","year":"1959"},{"key":"e_1_2_2_26_2","doi-asserted-by":"publisher","DOI":"10.2165\/00128072-200305010-00002"},{"key":"e_1_2_2_27_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.PHM.0000141131.66648.E9"},{"key":"e_1_2_2_28_2","doi-asserted-by":"publisher","DOI":"10.1002\/mus.880070406"},{"key":"e_1_2_2_29_2","doi-asserted-by":"publisher","DOI":"10.1097\/00002060-195904000-00005"},{"key":"e_1_2_2_30_2","volume-title":"Blue Book, 2003, Treatment of Cerebral Palsy with Botulinum Toxin \u2010 Principles, Clinical Practice, Atlas","author":"Berweck S","year":"2003"},{"key":"e_1_2_2_31_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.PHM.0000160006.51859.AE"}],"container-title":["Developmental Medicine &amp; 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