{"title":"肉毒毒素对痉挛性脑瘫患者肌肉质量和体积的影响：一项系统综述和荟萃分析。","authors":"Ai-Chieh Lin, Yu-Chi Su, Yu-Ching Lin","doi":"10.1097/PHM.0000000000002705","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>To comprehensively survey the impact of botulinum neurotoxin (BoNT) on muscle volume or mass in treating lower limb spasticity in individuals with spastic cerebral palsy (CP).</p><p><strong>Design: </strong>We searched PubMed, Embase, Web of Science, and the Cochrane Library up to May 15, 2024. We focused on changes in the volume or mass of the gastrocnemius, triceps surae, or entire distal lower limb muscles at various follow-up periods. Meta-regression analysis was conducted to assess the moderating effects of age and gross motor function classification system (GMFCS) level.</p><p><strong>Results: </strong>Our analysis included 11 cohort studies. A significant decrease in gastrocnemius muscle volume or mass was observed 2 to 3 months post-BoNT treatment (SMD -0.496, 95% CI [-0.810, -0.181]) but not at earlier (SMD -0.134, [-0.397, 0.129]) or later (SMD -0.223, [-1.199, 0.752]) periods. The triceps surae and entire distal lower limb muscles showed no changes. Older patients (P = 0.026) and those with GMFCS I-II levels (P = 0.0191) had more pronounced decreases.</p><p><strong>Conclusion: </strong>The present study showed a decrease in muscle volume or mass of the BoNT-injected gastrocnemius after a short follow-up period but not in the triceps surae or the distal lower limb in individuals with spastic CP.</p>","PeriodicalId":7850,"journal":{"name":"American Journal of Physical Medicine & Rehabilitation","volume":" ","pages":""},"PeriodicalIF":2.2000,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Effects of Botulinum Neurotoxin on Muscle Mass and Volume in Individuals with Spastic Cerebral Palsy: A Systematic Review and Meta-analysis.\",\"authors\":\"Ai-Chieh Lin, Yu-Chi Su, Yu-Ching Lin\",\"doi\":\"10.1097/PHM.0000000000002705\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>To comprehensively survey the impact of botulinum neurotoxin (BoNT) on muscle volume or mass in treating lower limb spasticity in individuals with spastic cerebral palsy (CP).</p><p><strong>Design: </strong>We searched PubMed, Embase, Web of Science, and the Cochrane Library up to May 15, 2024. We focused on changes in the volume or mass of the gastrocnemius, triceps surae, or entire distal lower limb muscles at various follow-up periods. Meta-regression analysis was conducted to assess the moderating effects of age and gross motor function classification system (GMFCS) level.</p><p><strong>Results: </strong>Our analysis included 11 cohort studies. A significant decrease in gastrocnemius muscle volume or mass was observed 2 to 3 months post-BoNT treatment (SMD -0.496, 95% CI [-0.810, -0.181]) but not at earlier (SMD -0.134, [-0.397, 0.129]) or later (SMD -0.223, [-1.199, 0.752]) periods. The triceps surae and entire distal lower limb muscles showed no changes. Older patients (P = 0.026) and those with GMFCS I-II levels (P = 0.0191) had more pronounced decreases.</p><p><strong>Conclusion: </strong>The present study showed a decrease in muscle volume or mass of the BoNT-injected gastrocnemius after a short follow-up period but not in the triceps surae or the distal lower limb in individuals with spastic CP.</p>\",\"PeriodicalId\":7850,\"journal\":{\"name\":\"American Journal of Physical Medicine & Rehabilitation\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":2.2000,\"publicationDate\":\"2025-02-04\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"American Journal of Physical Medicine & Rehabilitation\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1097/PHM.0000000000002705\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"REHABILITATION\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"American Journal of Physical Medicine & Rehabilitation","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/PHM.0000000000002705","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"REHABILITATION","Score":null,"Total":0}
引用次数: 0
摘要
目的：综合观察肉毒杆菌神经毒素（BoNT）治疗痉挛性脑瘫（CP）患者下肢痉挛时对肌肉体积或质量的影响。设计：我们搜索了PubMed， Embase， Web of Science和Cochrane Library，截止到2024年5月15日。我们关注腓肠肌、肱三头肌或整个下肢远端肌肉在不同随访时期的体积或质量变化。采用meta回归分析评估年龄和大肌肉运动功能分类系统（GMFCS）水平的调节作用。结果：我们的分析包括11项队列研究。bont治疗后2至3个月腓肠肌体积或质量显著下降（SMD -0.496, 95% CI[-0.810, -0.181]），但在早期（SMD -0.134,[-0.397, 0.129]）或后期（SMD -0.223,[-1.199, 0.752]）期间没有明显下降。肱三头肌表面和整个下肢远端肌肉没有变化。老年患者（P = 0.026）和GMFCS I-II水平的患者（P = 0.0191）下降更为明显。结论：目前的研究显示，在短时间的随访后，注射bont的腓肠肌肌肉体积或质量减少，但在痉挛性CP患者的三头肌表面或下肢远端没有减少。
Effects of Botulinum Neurotoxin on Muscle Mass and Volume in Individuals with Spastic Cerebral Palsy: A Systematic Review and Meta-analysis.
Objective: To comprehensively survey the impact of botulinum neurotoxin (BoNT) on muscle volume or mass in treating lower limb spasticity in individuals with spastic cerebral palsy (CP).
Design: We searched PubMed, Embase, Web of Science, and the Cochrane Library up to May 15, 2024. We focused on changes in the volume or mass of the gastrocnemius, triceps surae, or entire distal lower limb muscles at various follow-up periods. Meta-regression analysis was conducted to assess the moderating effects of age and gross motor function classification system (GMFCS) level.
Results: Our analysis included 11 cohort studies. A significant decrease in gastrocnemius muscle volume or mass was observed 2 to 3 months post-BoNT treatment (SMD -0.496, 95% CI [-0.810, -0.181]) but not at earlier (SMD -0.134, [-0.397, 0.129]) or later (SMD -0.223, [-1.199, 0.752]) periods. The triceps surae and entire distal lower limb muscles showed no changes. Older patients (P = 0.026) and those with GMFCS I-II levels (P = 0.0191) had more pronounced decreases.
Conclusion: The present study showed a decrease in muscle volume or mass of the BoNT-injected gastrocnemius after a short follow-up period but not in the triceps surae or the distal lower limb in individuals with spastic CP.
期刊介绍：
American Journal of Physical Medicine & Rehabilitation focuses on the practice, research and educational aspects of physical medicine and rehabilitation. Monthly issues keep physiatrists up-to-date on the optimal functional restoration of patients with disabilities, physical treatment of neuromuscular impairments, the development of new rehabilitative technologies, and the use of electrodiagnostic studies. The Journal publishes cutting-edge basic and clinical research, clinical case reports and in-depth topical reviews of interest to rehabilitation professionals.
Topics include prevention, diagnosis, treatment, and rehabilitation of musculoskeletal conditions, brain injury, spinal cord injury, cardiopulmonary disease, trauma, acute and chronic pain, amputation, prosthetics and orthotics, mobility, gait, and pediatrics as well as areas related to education and administration. Other important areas of interest include cancer rehabilitation, aging, and exercise. The Journal has recently published a series of articles on the topic of outcomes research. This well-established journal is the official scholarly publication of the Association of Academic Physiatrists (AAP).
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