Table 3 Summary of interventions and outcome measurements
Study | Intervention | Additional treatment | Follow-up (weeks) | Outcome measures |
|---|---|---|---|---|
Baker et al. [27] | 1. Placebo 2. Dysport;10–30 IU/Kg | Conventional PT and orthosis | 16 | - Mean of PROM of ankle DF (degrees) - Mean score of GMFM dimensions D and E (points) |
Bottos et al. [28] | 1. Dysport + AFO 2. Dysport + Casting - Dysport15-20 IU/Kg for both groups | Stretching, exercise, standing and gait training and provided AFO after BoNT-A | 16 | - Peak DF at stance (degrees) |
Buckon et al. [29] | 1. Control; no AFO 2. Hinged AFO, solid AFO, PLS; 6–12 h/day | No | 12 | - The 3D gait analysis data; kinematic (degrees) - Mean of PROM of ankle DF (degrees) - Mean score of GMFM dimensions D and E (points) |
Corry et al. [9] | 1. Casting; frequency of casting depended on clinical response 2. BoNT-A; 6–8 IU/Kg | No | 12 | - Mean composite scores of PRS (4 subscales, total 10 points/limb) - Mean of PROM of ankle DF (degrees) - The 3D gait analysis data; Mean range of ankle DF at initial contact, peak DF at stance, peak PF (degrees) |
Dalvand et al. [30] | 1. Control 2. Hinged AFO, solid AFO; applied after casting | NDT 3Â months (3 sessions per week, 1Â h daily) | 12 | - Mean difference of mean score of GMFM dimension D and E (points) |
Dursun et al.[13] | 1. PT 2. BoNT-A + PT - injected into the gastrocsoleus and tibialis posterior including hamstring and hip adductor 8–10 U/Kg | PT; Stretching, strengthening exercise, coordination training, training in daily activities | 4 | - Mean composite scores of CGAS (points) |
Dursun et al. [31] | 1. BoNT-A 2. BoNT-A + Casting injected Dysport 10–40 IU/Kg into gastrocsoleus, Casting × 3 times/week | PT (improve functional mobility, stretching) and OT; 1 h/session, 5 sessions/week | 12 | - Mean composite scores of OGS (points) - Mean of PROM of ankle DF (degrees) |
El-Etribi et al. [20] | 1. PT 2. BoNT-A + physiotherapy injected BoNT-A 3 U/Kg for hemiplegia and 6 U/Kg for diplegia into gastrocnemius | Stretching, strengthening exercise 1–1.5 h/session, 3 days/weeks | 12 | - Mean composite scores of PRS (6 subscales, total 14 points/limb) - Mean of PROM of ankle DF (degrees) |
Flett et al. [10] | 1. Casting; lasted for 4 weeks; reapplied at 2 weeks 2. BoNT-A; 4–8 U/Kg injected into gastrocsoleus | Night plaster in both groups | 48 | - Mean composite scores of PRS (2 subscales, total 7 points/limb) - Mean of PROM of ankle DF (degrees) - Mean score of GMFM dimension D,E (points) |
Hayek et al. [32] | 1. BoNT-A 2. BoNT-A + Casting injected BoNT-A into gastrocnemius (total dose of 20 U/Kg) retained casting at 2 weeks for 4 months | - Conventional PT 3 times/week - Brace | 48 | - Mean composite scores of OGS (points) - Mean of PROM of ankle DF + KE (degrees) - Mean of AROM of ankle DF (degrees) - Mean score of GMFM dimension D,E (points) |
Koman et al. [7] | 1. Placebo 2. BoNT-A; injected into medial and lateral gastrocnemius for 1 U/Kg of hemiplegia, 2 U/Kg of diplegia | Conventional PT | 6 | - Number of improvements of PRS (6 subscales, total 14 points/limb) |
Koman et al. [23] | 1. Placebo 2. BoNT-A; injected into medial and lateral gastrocnemius for 4 U/Kg of hemiplegia, 8 U/Kg of diplegia | Conventional PT | 8 | - Number of improvements of PRS (6 subscales, total 14 points/limb) |
Mass et al. [21] | 1. Control; No KAFO at night 2. KAFO for at least 6Â h/night | Physical therapy; gait and standing training | 48 | - Mean of PROM of ankle DF (degrees) |
Radtka et al. [33] | 1. Control; no AFO 2. Orthosis; solid AFO | 8 subjects received PT | 4 | - Mean range of ankle DF at initial contact and mid-stance (degrees) |
Radtka et al. [34] | 1. Control; no AFO 3. Orthosis; solid and hinged AFO | Preventing | 4 | - Mean range of ankle DF at initial contact, mid-stance, terminal stance (degrees) |
Rethlefsen et al. [35] | 1. Control 2. Orthosis; fixed AFO, articulated AFO | None | 6 | - The 3D gait analysis data: mean of ankle DF at initial and terminal stance (degrees) |
Sutherland et al. [12] | 1. Placebo 2. BoNT-A; injected into gastrocnemius for 4 U/Kg of hemiplegia, 4 U/Kg × 2 times for diplegia | None | 8 | - Number improvement of ankle DF at initial contact (degrees) - Number of improvements of VGA (graded 0–3 score, points) -Mean difference of PROM of ankle DF (degrees) |
Ubhi et al. [11] | 1. Placebo 2. BoNT-A; injected Dysport 15 U/Kg for hemiplegia, 25 U/Kg for diplegia at gastrocsoleus *3 cases were injected at hamstrings | Conventional PT with orthosis > 3 months before receive intervention | 12 | - Number of gait improvements of VGA (graded 0–4 score, points) - Number of improvement of GMFM dimension E (points) |
Xu et al. [36] | 1. PT 2. BoNT-A + PT - BoNT-A injected to ankle plantar flexors, 3 U/Kg for hemiplegia, 10 U/Kg for diplegia - PT in both groups; orthosis, NDT, stretching, strength and coordination training and task-specific training, and electrical stimulation (ES) 1–1.5 h/session, 5 days/week for 2 weeks | None | 12 | - Mean of PROM of ankle DF (degrees) - Mean score of GMFM dimension E (points) |
Yigitoglu et al. [37] | 1. BoNT- A 2. BoNT-A + electrical stimulation - ES applied to the gastrocnemius muscle for 20 min/1 time, for 10 days - BoNT-A10 U/Kg applied to the gastrocnemius and soleus muscles and home-based exercise programs for both groups | None | 12 | - Median of score of GMFM dimension E (points) |