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If left untreated, symptoms may result in the development of physical impairment and impede independent performance of daily tasks. Intramuscular injection of botulinum neurotoxin A is a relatively safe and effective adjunct to upper limb therapy. Botulinum neurotoxin A primarily aims to reduce muscle overactivity, thereby reducing the development of increased muscle stiffness that can lead to permanent changes. With a specific focus on the physiological action of botulinum neurotoxin A, this article describes the secondary symptoms of cerebral palsy and their different contributions. To highlight research directions and future implications for clinical practice, this article also documents the recent scientific evidence for upper limb botulinum neurotoxin A and proposes a preventive clinical model that aims to mitigate the effects of increasing upper limb impairment.<\/jats:p>","DOI":"10.1177\/0883073814533196","type":"journal-article","created":{"date-parts":[[2014,5,12]],"date-time":"2014-05-12T20:23:39Z","timestamp":1399926219000},"page":"1066-1076","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":19,"title":["Rationale for Using Botulinum Toxin A as an Adjunct to Upper Limb Rehabilitation in Children With Cerebral Palsy"],"prefix":"10.1177","volume":"29","author":[{"given":"Brian","family":"Hoare","sequence":"first","affiliation":[{"name":"Paediatric Rehabilitation Department, Monash Children\u2019s Hospital, Victoria, Australia"},{"name":"CPteaching, Victoria, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2014,5,11]]},"reference":[{"issue":"109","key":"bibr1-0883073814533196","first-page":"8","volume":"109","author":"Rosenbaum P","year":"2007","journal-title":"Dev Med Child Neurol"},{"key":"bibr2-0883073814533196","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2474-9-150"},{"key":"bibr3-0883073814533196","doi-asserted-by":"publisher","DOI":"10.1186\/1741-7015-7-65"},{"key":"bibr4-0883073814533196","doi-asserted-by":"publisher","DOI":"10.1016\/j.clineuro.2012.01.011"},{"key":"bibr5-0883073814533196","doi-asserted-by":"publisher","DOI":"10.1186\/1755-8794-2-44"},{"key":"bibr6-0883073814533196","unstructured":"Australian Cerebral Palsy Register Group: Australian cerebral palsy register report 2013 birth years 1993 to 2006. 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