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Case Reports in Medicine
Volume 2009, Article ID 985717, 4 pages
Case Report

Quantitative Effects on Proximal Joints of Botulinum Toxin Treatment for Gastrocnemius Spasticity: A 4-Year-Old Case Study

1Bioengineering Department, Politecnico di Milano, Piaza Leonardo da Vinci 32, 20133 Milano, Italy
2IRCCS “San Raffaele Pisana”, Tosinvest Sanità, Via della Pisana 235, 010163 Roma, Italy

Received 21 April 2009; Accepted 9 July 2009

Academic Editor: Nicola Smania

Copyright © 2009 Veronica Cimolin et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Botulinum toxin A (BTA) is a recognized treatment for the early management of spasticity in children with Cerebral Palsy. This study quantified with Gait Analysis (GA) the gait pattern of a 4-year-old diplegic child with calf contracture before, 5 days, and 3 months after BTA injections into gastrocnemius. Kinematic and kinetic data of main lower limb joints were investigated. After only 5 days, ankle dorsi-plantarflexion and knee flex-extension improved, but hip joint worsened, increasing its excessive flexion, to compensate the improvement in knee position of the treated limb and to obtain better stability. A worsening of hip power happened. After 3 months, all joints generally improved their position during gait cycle. Hip and knee joints increased their range of movement and improvements occurred at ankle kinematics and kinetisc, too; a better ankle position and an increase of its capacity of propulsion during terminal stance were evident.