Evaluation of spasticity and treatment selection in children with cerebral palsy
The man age ment of spacticity and re lated mo tor dis or ders in - cludes non-pharmacological, pharmacological and surgical meth ods. Long term man age ment of spasticity in ce re bral palsy (CP) should be based on ob jec tive cri te ria such as child’s age, rat ing scales for spasticity, gross mo tor func tion and gait, goniometry, etc. Un for tu nately, these cri te ria are not suf fi ciently ap plied not only in pri mary care but in spe cial ized cen ters as well. Aim of the study was to eval u ate the cri te ria used for the se lec tion of spasticity treat ment mo dal i ties and the con trol of their ef fi cacy. Meth ods. The anal y sis of med i cal re cords of 79 pa tients from 1 to 17 years old with dif fer ent spas tic forms of CP was per - formed in four health care in sti tu tions of two cit ies in Lith u a - nia. Re sults. Spasticity ac cord ing to the Ashwort scale was mea - sured just in 4 cases, gross mo tor func tion in 1. Oral mus cle re lax ants were ad min is tered to 39.2% of the pa tients, in most cases ep i sod i cally, for less than 1 month. Ef fec tive ness of mus cle re lax ants was not doc u mented in 74.2% cases; in 25.8% of them the sub jec tive opin ion was given by par ents or doc tors. Splints were ap plied in 54.8% of cases. Bot u li num toxin – A was used in 11 cases; in 8 of them in jec tions were started at the age of 2–3 years but con tin ued only in 4 pa - tients. Ob jec tive mea sure ments of spasticity were per formed only in 1 case in this group. Or tho pe dic sur gery was per - formed to 36.7%, the av er age age of the first op er a tion was 6.4 years. [...].