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Recent studies demonstrated BoNT-A-induced muscle atrophy and variable effects on gait pathology. This group-matched controlled study in children with SCP compared changes in muscle morphology 8\u201310 weeks post-BoNT-A treatment (n = 25, median age 6.4 years, GMFCS level I\/II\/III (14\/9\/2)) to morphological changes of an untreated control group (n = 20, median age 7.6 years, GMFCS level I\/II\/III (14\/5\/1)). Additionally, the effects on gait and spasticity were assessed in all treated children and a subgroup (n = 14), respectively. BoNT-A treatment was applied following an established integrated approach. Gastrocnemius and semitendinosus volume and echogenicity intensity were assessed by 3D-freehand ultrasound, spasticity was quantified through electromyography during passive muscle stretches at different velocities. Ankle and knee kinematics were evaluated by 3D-gait analysis. Medial gastrocnemius (p = 0.018, \u22125.2%) and semitendinosus muscle volume (p = 0.030, \u221216.2%) reduced post-BoNT-A, but not in the untreated control group, while echogenicity intensity did not change. Spasticity reduced and ankle gait kinematics significantly improved, combined with limited effects on knee kinematics. This study demonstrated that BoNT-A reduces spasticity and partly improves pathological gait but reduces muscle volume 8\u201310 weeks post-injections. Close post-BoNT-A follow-up and well-considered treatment selection is advised before BoNT-A application in SCP.<\/jats:p>","DOI":"10.3390\/toxins14100676","type":"journal-article","created":{"date-parts":[[2022,9,30]],"date-time":"2022-09-30T01:43:01Z","timestamp":1664502181000},"page":"676","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["The Short-Term Impact of Botulinum Neurotoxin-A on Muscle Morphology and Gait in Children with Spastic Cerebral Palsy"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0380-9174","authenticated-orcid":false,"given":"Nicky","family":"Peeters","sequence":"first","affiliation":[{"name":"Department of Rehabilitation Sciences, KU Leuven, 3001 Leuven, Belgium"},{"name":"Department of Rehabilitation Sciences, Ghent University, 9000 Ghent, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eirini","family":"Papageorgiou","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Sciences, KU Leuven, 3001 Leuven, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0406-6050","authenticated-orcid":false,"given":"Britta","family":"Hanssen","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Sciences, KU Leuven, 3001 Leuven, Belgium"},{"name":"Department of Rehabilitation Sciences, Ghent University, 9000 Ghent, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7800-3354","authenticated-orcid":false,"given":"Nathalie","family":"De Beukelaer","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Sciences, KU Leuven, 3001 Leuven, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lauraine","family":"Staut","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Sciences, KU Leuven, 3001 Leuven, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6651-2496","authenticated-orcid":false,"given":"Marc","family":"Degelaen","sequence":"additional","affiliation":[{"name":"Inkendaal Rehabilitation Hospital, 1602 Vlezenbeek, Belgium"},{"name":"Rehabilitation Research Group, Vrije Universiteit Brussel, 1090 Brussels, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine","family":"Van den Broeck","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Sciences, Ghent University, 9000 Ghent, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6327-8155","authenticated-orcid":false,"given":"Patrick","family":"Calders","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Sciences, Ghent University, 9000 Ghent, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hilde","family":"Feys","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Sciences, KU Leuven, 3001 Leuven, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8158-5535","authenticated-orcid":false,"given":"Anja","family":"Van Campenhout","sequence":"additional","affiliation":[{"name":"Department of Development and Regeneration, KU Leuven, 3000 Leuven, Belgium"},{"name":"Department of Orthopedic Surgery, University Hospitals Leuven, 3000 Leuven, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaat","family":"Desloovere","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Sciences, KU Leuven, 3001 Leuven, Belgium"},{"name":"Clinical Motion Analysis Laboratory, University Hospitals Leuven, Pellenberg, 3212 Leuven, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,9,29]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"7","DOI":"10.3389\/fped.2017.00021","article-title":"Cerebral Palsy\u2014Trends in Epidemiology and Recent Development in Prenatal Mechanisms of Disease, Treatment, and Prevention","volume":"5","author":"Stavsky","year":"2017","journal-title":"Front. 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