{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T14:22:46Z","timestamp":1793283766048,"version":"4.5.0"},"reference-count":23,"publisher":"American Academy of Pediatrics (AAP)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2016,2,1]]},"abstract":"<jats:sec>\n                  <jats:title>BACKGROUND:<\/jats:title>\n                  <jats:p>Although botulinum toxin is a well-established treatment of focal spasticity in cerebral palsy, most trials have been small, and few have simultaneously assessed measures of muscle tone and clinical benefit.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS:<\/jats:title>\n                  <jats:p>Global, randomized, controlled study to assess the efficacy and safety of abobotulinumtoxinA versus placebo in cerebral palsy children with dynamic equinus foot deformity. Patients were randomized (1:1:1) to abobotulinumtoxinA 10 U\/kg\/leg, 15 U\/kg\/leg, or placebo injections into the gastrocnemius-soleus complex (1 or both legs injected). In the primary hierarchical analysis, demonstration of benefit for each dose required superiority to placebo on the primary (change in Modified Ashworth Scale from baseline to week 4) and first key secondary (Physician\u2019s Global Assessment at week 4) end points.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS:<\/jats:title>\n                  <jats:p>Two hundred and forty-one patients were randomized, and 226 completed the study; the intention to treat population included 235 patients (98%). At week 4, Modified Ashworth Scale scores significantly improved with abobotulinumtoxinA; mean (95% confidence interval) treatment differences versus placebo were \u20130.49 (\u20130.75 to \u20130.23; P = .0002) for 15 U\/kg\/leg and \u20130.38 (\u20130.64 to \u20130.13; P = .003) for 10 U\/kg\/leg. The Physician\u2019s Global Assessment treatment differences versus placebo of 0.77 (0.45 to 1.10) for 15 U\/kg\/leg and 0.82 (0.50 to 1.14) for 10 U\/kg\/leg were also significant (both Ps &amp;lt; .0001). The most common treatment-related adverse event was muscular weakness (10 U\/Kg\/leg = 2; placebo = 1).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS:<\/jats:title>\n                  <jats:p>AbobotulinumtoxinA improves muscle tone in children with dynamic equinus resulting in an improved overall clinical impression and is well tolerated.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1542\/peds.2015-2830","type":"journal-article","created":{"date-parts":[[2016,1,27]],"date-time":"2016-01-27T01:08:42Z","timestamp":1453856922000},"source":"Crossref","is-referenced-by-count":60,"title":["AbobotulinumtoxinA for Equinus Foot Deformity in Cerebral Palsy: A Randomized Controlled Trial"],"prefix":"10.1542","volume":"137","author":[{"given":"Mauricio R.","family":"Delgado","sequence":"first","affiliation":[{"name":"Texas Scottish Rite Hospital for Children, Dallas, Texas;"},{"name":"University of Texas Southwestern Medical Center, Dallas, Texas;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ann","family":"Tilton","sequence":"additional","affiliation":[{"name":"Louisiana State University Health Center and Children\u2019s Hospital New Orleans, New Orleans, Louisiana;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barry","family":"Russman","sequence":"additional","affiliation":[{"name":"Shriner\u2019s Hospital for Children, Portland, Oregon;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oscar","family":"Benavides","sequence":"additional","affiliation":[{"name":"Centro de Rehabilitacion Infantil, Mexico City, Mexico;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcin","family":"Bonikowski","sequence":"additional","affiliation":[{"name":"Non-public Healthcare Unit Mazovian Neurorehabilitation and Psychiatry Center in Zagorze, Wiazowna, Poland;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jorge","family":"Carranza","sequence":"additional","affiliation":[{"name":"Hospital San Jos\u00e9 Celaya, Celaya, Guanajuato, Mexico;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward","family":"Dabrowski","sequence":"additional","affiliation":[{"name":"Children\u2019s Hospital of Michigan, Detroit, Michigan;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nigar","family":"Dursun","sequence":"additional","affiliation":[{"name":"Kocaeli University Medical Faculty, Izmit, Turkey;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Gormley","sequence":"additional","affiliation":[{"name":"Gillette Children\u2019s Specialty Healthcare, St Paul, Minnesota;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marek","family":"Jozwiak","sequence":"additional","affiliation":[{"name":"Department of Pediatric Orthopedics and Traumatology K. 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