Efficacy and safety of botulinum toxin A injection for the spastic equinus foot in children with cerebral palsy：a meta-analysis

Abstract:

Objective：To systematically review the efficacy and safety of botulinum toxin A injection for the spastic equinus foot in children with cerebral palsy by analyzing the domestic and foreign relevant literature. Methods：All relevant controlled clinical re－searches（randomized controlled trials，RCTs） about the efficacy and safety of botulinum toxin A injection for the spastic equinus foot in children with cerebral palsy from Cochrane Collaboration，Cochrane Library，Medline，PubMed，Chinese periodical full-text database，Wanfang Standards Database and other Chinese and English database were searched，as well as the relevant literatures and confer－ence proceedings. Quality of enrolled literatures was assessed；Meta analysis calculations are made by ReyMan 5.3. Results：A total of seven studies with a total of 576 cases were enrolled including 360 cases of botulinum toxin A and 216 cases of placebo. There was no significant differences in the incidence of adverse events（RR=1.40，95%CI=0.99 to 1.97，P=0.06） between botulinum toxin A and placebo in the treatment of the spastic equinus foot in cerebral palsy. In the gait analysis（RR=2.29，95%CI=1.56 to 3.37，P＝0.000），There were significant differences in the degree of dynamic muscle spasm（MD=8.76，95%CI=5.86 to 11.66，P＝0.000），the degree of arrest muscle spasm（MD=4.88，95%CI=0.96 to 8.80，P=0.01），quality of life change difference（RR=1.49，95%CI=1.08 to 2.06，P=0.02） between two groups. Conclusion：Botulinum toxin A in－jection for the spastic equinus foot in children with cerebral palsy is safe and effective. Therefore，it is worth promoting and applying in clinic.