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OPTIMIZING REHABILITATION THROUGH BOTULINUM TOXIN THERAPY
IN CHILDREN UNDER 5 YEARS WITH CEREBRAL PALSY
Assistant:
Ermatov Farhod Akhmedovich
Central Asian Medical University
International Medical University
Department of Pediatrics and Pediatric Surgery
Relevance of the topic:
Cerebral palsy (CP) is a neurological syndrome resulting from hypoxic-ischemic brain
damage occurring before or during childbirth. It is characterized by movement disorders and
altered muscle tone. The period under 5 years of age is marked by intense neuroplasticity,
making timely and effective rehabilitation crucial for the child’s neurological development.
In this context, botulinum toxin-based injection therapy (botulinotherapy) has gained
prominence in recent years as an effective method to reduce spasticity and promote
functional recovery.
Aim of the study:
To assess the clinical effectiveness of botulinotherapy in children under the age of 5
diagnosed with cerebral palsy and to integrate this treatment into rehabilitation programs to
optimize outcomes.
Materials and Methods:
The study was conducted during 2024–2025 at the “Mother and Child” Genesis Clinic in
Fergana city. A total of 40 children aged 2–5 years with a confirmed diagnosis of CP
participated in the study. They were divided into two groups:
• Main group (n=20): received a standard rehabilitation program (physical therapy,
occupational therapy, speech therapy) along with botulinum toxin type A (Dysport®)
injections.
• Control group (n=20): received only the standard rehabilitation program.
Injections were administered anatomically into selected muscles: gastrocnemius, adductor
longus, and biceps brachii. Dosage was calculated individually based on div weight and
degree of spasticity. Effectiveness was evaluated using the Modified Ashworth Scale (MAS),
Gross Motor Function Measure (GMFM-66), and Pediatric Evaluation of Disability
Inventory (PEDI) at 1 and 3 months post-treatment.
Results and Discussion:
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In the main group, muscle tone decreased from an average of 2.5 to 1.5 on the Ashworth
scale (p<0.01). GMFM-66 scores increased by 15% after 3 months, and significant positive
dynamics in daily motor activity were observed using PEDI. In the control group,
improvements were less pronounced. Botulinotherapy was well tolerated, and no adverse
effects were recorded.
Conclusion:
Botulinum toxin therapy in children under 5 years with cerebral palsy is an effective and
safe method to reduce spasticity, improve motor function, and support social adaptation. The
study conducted at the “Mother and Child” Genesis Clinic confirmed the practical
importance of integrating botulinotherapy into pediatric neurorehabilitation.
References:
1. Nazarova M.M., Aliev U.J. Botulinotherapy in cerebral palsy: new opportunities.
Uzbekistan Pediatric Journal, 2022; No.2: 45–49.
2. Heinen F. et al. Botulinum toxin A in the treatment of cerebral palsy. Pediatrics, 2021;
147(4): e2020032365.
3. Delgado M.R. et al. Practice parameter: botulinum toxin for spasticity in children.
Neurology, 2020; 94(8): 359–366.
4. Sharipova D.N., Juraev A.R. Pediatric rehabilitation: modern approaches. Tashkent: Ilm,
2023.
5. World Health Organization. International guidelines for rehabilitation of cerebral palsy.
WHO, 2022.
