CP Muscle Research: Quantifying the effect of intramuscular Botulinum toxin A on calf muscle spasticity, structure and function in children with CP
The Project: An opportunity exists for a high calibre higher degree research student to pursue a research career in paediatrics with a focus on the clinical measurement and management of lower limb spasticity in children aged 5-12 years of age with cerebral palsy. The project is a collaboration between researchers from the Queensland Cerebral Palsy and Rehabilitation Research Centre (QCPRRC) and clinicians from the Queensland Paediatric Rehabilitation Service (QPRS) and will integrate directly into the Botulinum toxin clinic, Lady Cilento Children's Hospital. The project would ideally suit a physiotherapist or exercise physiologist with experience in paediatrics and/or biomechanics. The research will primarily focus on developing and validating a new, instrumented device to quantify muscle spasticity in a clinical setting and evaluate the efficacy of intramuscular Botulinum toxin A (BoNT-A). The project will also quantify the effects of intramuscular Botulinum toxin-A on muscle structure and function using quantitative Portable Spasticity Assessment Device (PSAD), ultrasound, and physical function and performance using validated clinical assessments.
The Portable Spasticity Assessment Device (PSAD) is an instrumented spasticity measurement tool developed by research from The University of Copenhagen that enables objective measurement of static and dynamic causes of increased muscle stiffness in a clinical setting. Because the PSAD is used in conjunction with standard clinical assessments of range of motion it represents an innovative, efficient and clinically viable alternative to existing assessments for evaluating indications and efficacy of BoNT-A therapy. Combined with tools that objectively measure muscle morphology and quality (3DUS) and walking quality using 2D video analysis, the PSAD will provide a comprehensive clinical toolbox to evaluate the efficacy of BoNT-A therapy in children with CP.
Research Aims: In a prospective pre-post cohort study of young children with CP receiving a single intramuscular BoNT-A treatment to the calf muscle, this study aims to:
- Evaluate the in calf muscle stiffness and spasticity using the PSAD.
- Evaluate the responsiveness and predictive ability of the PSAD compared to the Modified Tardieu Scale and Modified Ashworth Scale.
- Evaluate the relationship between short-medium changes in calf muscle stiffness, spasticity, size and quality, walking quality and functional ability.
