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Effects of Botulinum Toxin Type A in Adults With Cerebral Palsy

This study has been completed.
The Royal Norwegian Ministry of Health
Information provided by:
Sunnaas Rehabilitation Hospital Identifier:
First received: February 5, 2007
Last updated: February 23, 2009
Last verified: February 2009
The purpose of this project is to investigate if there is a significant difference in active joint range of motion, questionnaire on gait function and health related quality of life between patients randomized to treatment with Botulinum toxin type A and patients randomized to placebo treatment.

Condition Intervention Phase
Cerebral Palsy
Drug: Botulinum toxin type A (Botox)
Drug: placebo (saline)
Phase 4

Study Type: Interventional
Study Design: Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double Blind (Participant, Care Provider, Investigator, Outcomes Assessor)
Primary Purpose: Treatment
Official Title: A Randomized Controlled Trial on Effects of Botulinum Toxin Type A in Adults With Cerebral Palsy

Resource links provided by NLM:

Further study details as provided by Sunnaas Rehabilitation Hospital:

Primary Outcome Measures:
  • Ankle sagittal kinematic with corresponding knee and hip data (3D-gait analysis) [ Time Frame: 8 week ]
  • Summary measure of health related quality of life (SF-36) [ Time Frame: 8 week , 16 week ]

Secondary Outcome Measures:
  • Stiffness/spasticity according to VAS [ Time Frame: 8 week, 16 week ]
  • Questionnaire gait function [ Time Frame: 8 week, 16 week ]
  • Spasticity in ankle, knee and hip according to Modified Ashworth Scale [ Time Frame: 8 week, ]
  • 3D-gait data (Kinetics,Temporospatial (stride length, velocity) [ Time Frame: 8 week ]
  • Global Scale [ Time Frame: 8 week, 16 week ]
  • Timed Up and Go [ Time Frame: 8 week ]
  • 6 minutes walking test [ Time Frame: 8 week ]
  • Registrations of sample characteristics [ Time Frame: 0 week ]
  • Registration of adverse reactions [ Time Frame: 8 week, 16 week ]
  • Pain according to VAS [ Time Frame: 8 week, 16 week ]

Estimated Enrollment: 66
Study Start Date: January 2007
Study Completion Date: January 2009
Primary Completion Date: January 2009 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: I
Drug: Botulinum toxin type A (Botox)
Placebo Comparator: II Drug: placebo (saline)

Detailed Description:

Cerebral palsy (CP) is a constellation of symptoms and conditions defined as lifelong motor dysfunction resulting rom a non-progressive brain lesion occurring pre-, peri- or postnatal before the second year of life. CP consists of different aspect of motor disorder including spasticity, paresis, incoordination and dystonia

There is scarce knowledge about the association between spasticity, pain and physical function in the adult CP-population, and the systematic follow up of patients with CP typically ends at the age of eighteen. Frequently used intervention in spastic cerebral palsy for children with gait problems are injections with Botulinum toxin type A (Btx-A) in leg and thigh muscles, and three dimensional-gait analysis has become a standard procedure in treatment decision and evaluation.

Botulinum toxin A (Btx- A) is a highly effective treatment in the management of spasticity. The first reported success of use of Btx-A in children with cerebral palsy was made in 1993 by Koman et al. Subsequently, randomized controlled studies on children with spastic type of cerebral palsy has documented that Btx-A is effective and safe in the management of muscle spasticity in children with CP. There is an implicit, and as of yet, unproven assumption that there is no indication for this treatment in the adult CP-population.


Ages Eligible for Study:   18 Years to 65 Years   (Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • Unilateral or bilateral spastic CP
  • Modified Ashworth Scale (MAS) ≥ 2 in ankle- or knee joint muscles.
  • ≥ 18 year of age, ≤ 65 year of age
  • Ambulant without walking aids minimum 10 metres in functional equines and/or with pathological knee extension or flexion pattern.

Exclusion Criteria:

  • Cognitive impairment.
  • No spasticity (MAS < 2 )
  • < 18 year of age
  • Not ambulant without walking aids
  • Pregnant or planning pregnancy
  • Btx-A treatment last 6 months
  • Orthopedic surgery lower extremity last 18 months
  • Obvious skeletal/joint deformity where orthopedic surgery is indicated
  • Other diseases which can affect level of function (rheumatoid or neurological )
  • New treatment the past four weeks which affect the musculoskeletal system (pain killers, physical therapy, acupuncture)
  Contacts and Locations
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Please refer to this study by its identifier: NCT00432055

Sunnaas Rehabilitation Hospital
Bjoernemyr, Nesoddtangen, Norway, 1450
Sponsors and Collaborators
Sunnaas Rehabilitation Hospital
The Royal Norwegian Ministry of Health
Study Chair: Johan K Stanghelle, Professor MD Research Departement, Sunnaas Rehabilitation Hospital
  More Information

Responsible Party: Johan K Stanghelle, Sunnaas Rehabilitation Hospital Identifier: NCT00432055     History of Changes
Other Study ID Numbers: 20624503
EudraCTnumber: 2006-001427-19
Study First Received: February 5, 2007
Last Updated: February 23, 2009

Keywords provided by Sunnaas Rehabilitation Hospital:
Cerebral Palsy
Spastic contractures
Botulinum toxin type A

Additional relevant MeSH terms:
Cerebral Palsy
Neurologic Manifestations
Nervous System Diseases
Signs and Symptoms
Brain Damage, Chronic
Brain Diseases
Central Nervous System Diseases
Botulinum Toxins, Type A
Botulinum Toxins
Neuromuscular Agents
Peripheral Nervous System Agents
Physiological Effects of Drugs
Acetylcholine Release Inhibitors
Membrane Transport Modulators
Molecular Mechanisms of Pharmacological Action
Cholinergic Agents
Neurotransmitter Agents processed this record on April 28, 2017