{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,5]],"date-time":"2026-01-05T21:30:17Z","timestamp":1767648617861,"version":"3.40.5"},"reference-count":55,"publisher":"American Academy of Pediatrics (AAP)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2001,11,1]]},"abstract":"\n Background.<\/jats:title>\n Focal spasticity of the gastrocnemius-soleus muscles causes equinus gait in children with cerebral palsy (CP). Botulinum toxin type A (BTX-A), a neuromuscular blocking agent, reduces muscle tone\/overactivity in dystonia, stroke, and CP.<\/jats:p>\n <\/jats:sec>\n \n Objective.<\/jats:title>\n A prospective, open-label, multicenter clinical trial evaluated the long-term safety and efficacy of repeated intramuscular injections of BTX-A on equinus gait in CP children.<\/jats:p>\n <\/jats:sec>\n \n Methods.<\/jats:title>\n Nine centers enrolled 207 children. BTX-A injections (4 U\/Kg) were given approximately every 3 months (maximum dose 200\u2009U per treatment). Outcome measures included a Physician Rating Scale of gait, ankle range of motion measurements, and the incidence and profile of adverse events.<\/jats:p>\n <\/jats:sec>\n \n Results.<\/jats:title>\n One hundred fifty-five (75%) of 207 children completed at least 1 year with a total of 302 patient years of BTX-A treatment. The mean duration of BTX-A exposure was 1.46 years per patient. Dynamic gait pattern on the Physician Rating Scale improved in 46% of patients (86\/185) at first follow-up. The response was maintained in 41% to 58% of patients for 2 years. Both gait pattern and ankle position improved at every visit. The most common treatment-related adverse events included increased stumbling, leg cramps, leg weakness, and calf atrophy in 1% to 11% of patients. No treatment-related serious adverse events were reported. Only 6% (7\/117) of patients with pre- and postantibody samples had both detectable antibodies and a subsequent treatment failure.<\/jats:p>\n <\/jats:sec>\n \n Conclusion.<\/jats:title>\n BTX-A proved both safe and effective in the chronic management of focal muscle spasticity in children with equinus gait.<\/jats:p>\n <\/jats:sec>","DOI":"10.1542\/peds.108.5.1062","type":"journal-article","created":{"date-parts":[[2004,8,13]],"date-time":"2004-08-13T23:55:51Z","timestamp":1092441351000},"page":"1062-1071","source":"Crossref","is-referenced-by-count":132,"title":["Botulinum Toxin Type A Neuromuscular Blockade in the Treatment of Equinus Foot Deformity in Cerebral Palsy: A Multicenter, Open-Label Clinical Trial"],"prefix":"10.1542","volume":"108","author":[{"given":"L. 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