Analyzing the Impacts of Rectus Femoris Transferring and Botulinum Toxin on Cerebral Palsy: a Case study

Cerebral palsy is a group of different disorders that affect mobility, muscle tone and erectile structure. This condition is usually caused by damage to the brain during growth and development, usually before birth [1]. Houwen et al. [2] evaluated the effect of Botolinum Toxin treatment on the patterns of muscle activation of the rectus femoris and this study showed that BTX-A injection did not improve lower limb muscle activation patterns during walking. Muthusamy et al. [3] examined the effect of rectus femoris surgery on thirty-eight patients with CP and Patients had a significant improvement in postoperative KROM when preoperative KROM was less than 80% normal.Tedroff et al. [4] was studied in 94 children with cerebral palsy who received BoNT-A injection and results showed that BoNT-A could be effective in reducing muscle tone over a longer period of time. "How does the combination of rectus femoris transfer and botulinum toxin affect gait kinematics, range of motion, and muscle activation patterns in patients with cerebral palsy, and how do the effects compare to each treatment alone?" The study involved a motion data of patient with cerebral palsy and a normal child.a simulation model was created using the inverse dynamics method to analyze the joint angles and muscle forces during walking in opensim. The forward dynamic method was then used to simulate the effects of rectus femoris transfer and Botulinum Toxin injection on muscle weakness and surgery.Download : Download high-res image (149KB)Download : Download full-size image using SPSS V.19 software (ANOVA) and output data obtained from modeling. For right hip flexion, the Transferring group is significantly different from the Botolinum toxin group (P<0.001) and can be due to the weakness of the thigh extensor muscles in the Botulinum Toxin group. For right knee flexion, the surgical group is significantly different from the Botolinum Toxin group (P<0.001) and the patient's initial model and it can be concluded that rectus femoris surgery can cause initial relative improvement in the patient and strengthening the extensor knee muscles can help improve the patient's movement. For left hip flexion, the surgical group is significantly different from the Botolinum Toxin group (P<0.001) and can be due to the weakness of the extensor thigh muscles in the Botolinum Toxin group. For left knee flexion,the surgical group is significantly different from Botolinum Toxin group (P<0.001) and the patient's initial model and it can be concluded that rectus femoris Transferring surgery can cause initial relative improvement in the patient The results show that therapeutic interventions including surgery in the first stage are more effective than botulinum toxin and muscle weakness by botulinum toxin injection in the short term may not be effective and require scheduled studies over long periods of time.