Clinical and instrumental gait assessment in adult with cerebral palsy and gluteus medius anterior fibers spasticity before and after local treatment with botulinum toxin

Abstract

Gait with internal hip rotation is often observed in adult with cerebral palsy both in diplegic and hemiplegic forms. Walking disabilities could be the consequence of gluteus medius anterior fibers spasticity. A monocentric prospective pilot study was to assess the clinical and paraclinical progression of hip internal rotation, velocity and Functional Ambulation Performance (FAP) score index. We included eight patients (nine hips) with a follow-up to five weeks. Clinical (questionnaire, spasticity) and instrumental (walk on “GAITRite ®” ) assessments were performed at the beginning and at the end of the study. The FAP was significantly higher (10%) after botulinum toxin (80 to 87, P < 0.05). There was no significant impact on internal rotation and velocity. Patients felt better with a fluider gait and less fall. Botulinum toxin improved gait performances in adult with cerebral palsy and gluteus medius anterior fibers spasticity. A randomized prospective multicentric study is required to confirm the preliminary results and to assess the impact of quality of life.