{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T16:34:17Z","timestamp":1787675657452,"version":"build-2784847793"},"reference-count":45,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,2,6]],"date-time":"2025-02-06T00:00:00Z","timestamp":1738800000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Rehabil. Sci."],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>Focal vibration therapy (FVT) is increasingly used in the treatment of spastic paresis. In adults, it has been shown to reduce spasticity and to increase torque production from the vibrated muscles by restoring reciprocal inhibition of antagonists, thereby improving overall gait. In children with spastic cerebral palsy (CP), FVT has also been suggested to reduce spasticity, increase torque production and improve gait function, but evidence is limited.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We report the case of a child with unilateral spastic CP (USCP) and equinus gait (GFMCS II level) with (i) ankle dorsiflexor paresis, (ii) ankle plantar flexor overactivity, especially in gastrosoleus complex and peroneus longus, (iii) spastic myopathy, affecting gastrosoleus complex in particular, and (iv) calf pain seemingly related to muscle overactivity. The child was treated with a two-month program of alternating dorsiflexor and plantar flexor focal vibration therapy (FVT) and botulinum neurotoxin A (BoNT-A) injections into plantar flexors, alongside conventional physiotherapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results and discussion<\/jats:title><jats:p>Clinical evaluations during the two-month program showed (i) improved walking speed (ii) decreased ankle dorsiflexor paresis and ankle plantar flexor overactivity, especially spastic co-contraction and spasticity, (iii) improved passive extensibility in plantar flexors, and (iv) reduced pain. This is the first report of the combination of FVT and BoNT-A injections having promising effects on equinus gait in USCP.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fresc.2025.1454109","type":"journal-article","created":{"date-parts":[[2025,2,6]],"date-time":"2025-02-06T07:13:21Z","timestamp":1738826001000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":4,"title":["Case Report: Combination of focal vibration therapy and botulinum toxin injections to treat equinus gait in a child with unilateral spastic cerebral palsy"],"prefix":"10.3389","volume":"6","author":[{"given":"Christophe","family":"Boulay","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacques-Olivier","family":"Coq","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Morgan","family":"Sangeux","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guillaume","family":"Authier","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexis","family":"Ulian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maud","family":"Pradines","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marjolaine","family":"Baude","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B\u00e9atrice","family":"Desnous","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Luc","family":"Jouve","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernard","family":"Parratte","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emilie","family":"Peltier","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S\u00e9bastien","family":"Pesenti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Michel","family":"Gracies","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,2,6]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"431","DOI":"10.1016\/j.rehab.2019.07.003","article-title":"From congenial paralysis to post-early brain injury developmental condition: where does cerebral palsy actually stand?","volume":"63","author":"Chabrier","year":"2020","journal-title":"Ann Phys Rehabil Med"},{"key":"B2","doi-asserted-by":"publisher","first-page":"15082","DOI":"10.1038\/nrdp.2015.82","article-title":"Cerebral palsy","volume":"2","author":"Graham","year":"2016","journal-title":"Nat Rev Dis Primers"},{"key":"B3","doi-asserted-by":"publisher","first-page":"426","DOI":"10.1016\/j.rehab.2018.10.004","article-title":"The neurophysiology of deforming spastic paresis: a revised taxonomy","volume":"62","author":"Baude","year":"2019","journal-title":"Ann Phys Rehabil Med"},{"key":"B4","doi-asserted-by":"publisher","first-page":"102665","DOI":"10.1016\/j.jelekin.2022.102665","article-title":"Reduced plantar-flexors extensibility but improved selective motor control associated with age in young children with unilateral cerebral palsy and equinovalgus gait","volume":"65","author":"Boulay","year":"2022","journal-title":"J Electromyogr Kinesiol"},{"key":"B5","doi-asserted-by":"publisher","first-page":"105459","DOI":"10.1016\/j.clinbiomech.2021.105459","article-title":"Agonist and antagonist activation at the ankle monitored along the swing phase in hemiparetic gait","volume":"89","author":"Gh\u00e9dira","year":"2021","journal-title":"Clin Biomech"},{"key":"B6","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.pediatrneurol.2023.01.019","article-title":"Improved gait and radiological measurements after injection of Botulinum toxin into peroneus Longus in young children with USCP and equinovalgus gait","volume":"142","author":"Boulay","year":"2023","journal-title":"Pediatr Neurol"},{"key":"B7","doi-asserted-by":"publisher","first-page":"89","DOI":"10.1016\/j.clinph.2017.10.023","article-title":"On Denny-Brown\u2019s \u2018spastic dystonia\u2019 \u2013 What is it and what causes it?","volume":"129","author":"Lorentzen","year":"2018","journal-title":"Clin Neurophysiol"},{"key":"B8","doi-asserted-by":"publisher","first-page":"552","DOI":"10.1002\/mus.20285","article-title":"Pathophysiology of spastic paresis. 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