Children undergoing treatment with botulinum toxin: the role of the physical therapist.

For the cerebral palsy patient undergoing botulinum toxin (BTX) therapy, the physical therapist is involved in each step of treatment, from patient selection to outcome assessment. Prior to treatment, the therapist collects detailed baseline information, including assessment of motor ability, functional activities, current therapies and assistive devices, and the concerns of the caregiver and family. After BTX injection, the therapy program may include exercise, neurodevelopmental training, functional training, modalities, splinting, casting, orthoses, and positioning. The weakness brought on by BTX treatment provides important opportunities for functional retraining. It may also necessitate new assistive devices or modifications in the old ones.