{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,14]],"date-time":"2026-11-14T02:38:04Z","timestamp":1794623884588,"version":"4.9.1"},"reference-count":28,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2010,1,15]],"date-time":"2010-01-15T00:00:00Z","timestamp":1263513600000},"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":[[2010,2]]},"abstract":"<jats:p><jats:bold>Aim\u2002<\/jats:bold> The objective was to determine whether specific intrinsic (age, pattern of cerebral palsy [CP], child\u2019s motivation) and extrinsic (number of treatments, parenting stress) characteristics were associated with responsiveness to botulinum toxin A (BoNT\u2010A) injections in children with CP 3\u2003months after injection into the gastrocnemius muscle.<\/jats:p><jats:p><jats:bold>Method\u2002<\/jats:bold> Children with hemiplegia or diplegia recruited from a BoNT\u2010A programme were evaluated before and 3\u2003months following injection of BoNT\u2010A into the gastrocnemius. Outcome measures included muscle tone, range of motion, gait pattern, level of ambulation, gross motor function, and functional independence. Determinants of responsiveness to BoNT\u2010A considered were age, number of treatments, distribution of CP, parenting stress, and motivation.<\/jats:p><jats:p><jats:bold>Results\u2002<\/jats:bold> Thirty\u2010one children were recruited (17 males, 14 females) \u2013 22 with hemiplegia and nine with diplegia. Twenty\u2010eight were classified at Gross Motor Function Classification System (GMFCS) level I and three at level III. The mean age was 6\u2003years 4\u2003months (SD 2y 11mo). Younger age (<jats:italic>p<\/jats:italic>=0.015) and fewer number (<jats:italic>p<\/jats:italic>=0.024) of BoNT\u2010A treatments were associated with greater change in gross motor function. Child\u2019s motivation and parenting stress were significantly associated with improvements in muscle tone (<jats:italic>p<\/jats:italic>=0.006\u20130.017), passive range of motion (<jats:italic>p<\/jats:italic>=0.008\u20130.033), gait pattern (<jats:italic>p<\/jats:italic>=0.005\u20130.042), level of ambulation (<jats:italic>p<\/jats:italic>=0.001\u20130.043), and functional independence (<jats:italic>p<\/jats:italic>=0.004\u20130.027).<\/jats:p><jats:p><jats:bold>Interpretation\u2002<\/jats:bold> The results indicate that child, family, and treatment characteristics influence the degree of responsiveness to BoNT\u2010A treatment. The contribution of contextual factors (personal and environmental) on responsiveness may be underappreciated in children with CP.<\/jats:p>","DOI":"10.1111\/j.1469-8749.2009.03365.x","type":"journal-article","created":{"date-parts":[[2010,1,15]],"date-time":"2010-01-15T18:59:09Z","timestamp":1263581949000},"page":"186-193","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Determinants of responsiveness to botulinum toxin, casting, and bracing in the treatment of spastic equinus in children with cerebral palsy"],"prefix":"10.1111","volume":"52","author":[{"given":"RITA","family":"YAP","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"ANNETTE","family":"MAJNEMER","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"THIERRY","family":"BENAROCH","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"MARIE\u2010ANDREE","family":"CANTIN","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2010,1,15]]},"reference":[{"issue":"2","key":"e_1_2_8_2_2","first-page":"S15","article-title":"Botulinum toxin A in the management of children with cerebral palsy: indications and outcome","volume":"4","author":"Boyd R","year":"1997","journal-title":"Eur J Neurol"},{"key":"e_1_2_8_3_2","doi-asserted-by":"publisher","DOI":"10.1177\/088307380101600107"},{"key":"e_1_2_8_4_2","doi-asserted-by":"publisher","DOI":"10.1097\/01241398-199405000-00005"},{"key":"e_1_2_8_5_2","doi-asserted-by":"publisher","DOI":"10.1097\/00004694-200001000-00022"},{"key":"e_1_2_8_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0966-6362(99)00012-0"},{"key":"e_1_2_8_7_2","doi-asserted-by":"publisher","DOI":"10.1136\/adc.83.6.481"},{"key":"e_1_2_8_8_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-8749.1994.tb11864.x"},{"key":"e_1_2_8_9_2","first-page":"129","article-title":"The role of botulinum toxin in the treatment of lower limb spasticity in children with cerebral palsy \u2013 a pilot study","volume":"33","author":"Zelnick N","year":"1997","journal-title":"Isr J Med Sci"},{"key":"e_1_2_8_10_2","doi-asserted-by":"publisher","DOI":"10.1177\/08830738050200080501"},{"key":"e_1_2_8_11_2","doi-asserted-by":"publisher","DOI":"10.1177\/088307380201700407"},{"key":"e_1_2_8_12_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1468-1331.2001.00044.x"},{"key":"e_1_2_8_13_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-1331.1999.tb00033.x"},{"key":"e_1_2_8_14_2","doi-asserted-by":"publisher","DOI":"10.1097\/01202412-200507000-00007"},{"key":"e_1_2_8_15_2","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-200601000-00019"},{"key":"e_1_2_8_16_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-8749.1999.tb00589.x"},{"key":"e_1_2_8_17_2","doi-asserted-by":"crossref","first-page":"598","DOI":"10.1093\/ptj\/80.6.598","article-title":"A multivariate model of determinants of motor change for children with cerebral palsy","volume":"80","author":"Bartlett DJ","year":"2000","journal-title":"Phys Ther"},{"key":"e_1_2_8_18_2","volume-title":"ICF Short Version","author":"International Classification of Functioning, Disability and Health","year":"2001"},{"key":"e_1_2_8_19_2","doi-asserted-by":"publisher","DOI":"10.1093\/ptj\/67.2.206"},{"key":"e_1_2_8_20_2","doi-asserted-by":"crossref","first-page":"304","DOI":"10.1097\/01241398-199805000-00006","article-title":"Botulinum toxin A compared with stretching casts in the treatment of spastic equinus: a randomised prospective trial","volume":"18","author":"Corry IS","year":"1998","journal-title":"J Pediatr Orthop"},{"key":"e_1_2_8_21_2","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1097\/01241398-200001000-00017","article-title":"Reliability and validity of the Gillette Functional Assessment Questionnaire as an outcome measure in children with walking disabilities","volume":"20","author":"Novacheck TF","year":"2000","journal-title":"J Pediatr Orthop"},{"key":"e_1_2_8_22_2","doi-asserted-by":"publisher","DOI":"10.1093\/ptj\/80.9.873"},{"key":"e_1_2_8_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-9993(97)90302-6"},{"key":"e_1_2_8_24_2","volume-title":"Parenting Stress Index","author":"Abidin RR","year":"1995"},{"key":"e_1_2_8_25_2","volume-title":"The Dimensions of Mastery Questionnaire: a manual about its development, psychometrics and use [Internet]","author":"Morgan GA","year":"2007"},{"key":"e_1_2_8_26_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-8749.2003.tb00885.x"},{"key":"e_1_2_8_27_2","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-200411000-00003"},{"key":"e_1_2_8_28_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-8749.2005.tb01215.x"},{"key":"e_1_2_8_29_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.gaitpost.2004.12.002"}],"container-title":["Developmental Medicine &amp; Child Neurology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fj.1469-8749.2009.03365.x","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/j.1469-8749.2009.03365.x","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,16]],"date-time":"2023-10-16T07:24:05Z","timestamp":1697441045000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/j.1469-8749.2009.03365.x"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2010,1,15]]},"references-count":28,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2010,2]]}},"alternative-id":["10.1111\/j.1469-8749.2009.03365.x"],"URL":"https:\/\/doi.org\/10.1111\/j.1469-8749.2009.03365.x","archive":["Portico"],"relation":{},"ISSN":["0012-1622","1469-8749"],"issn-type":[{"value":"0012-1622","type":"print"},{"value":"1469-8749","type":"electronic"}],"subject":[],"published":{"date-parts":[[2010,1,15]]},"assertion":[{"value":"2010-01-15","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}