Evidence map›Paper›PMID 20101040›Full record

GuidelineNeurology2010

Practice parameter: pharmacologic treatment of spasticity in children and adolescents with cerebral palsy (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology and the Practice Committee of the Child Neurology Society.

Quality Standards Subcommittee of the American Academy of Neurology and the Practice Committee of the Child Neurology Society, M R Delgado, D Hirtz, M Aisen, S Ashwal, D L Fehlings, J McLaughlin, L A Morrison, M W Shrader, A Tilton and 1 more

4 registry-linked trialsOpen access · bronzeAbstract readPractice GuidelineReview
PubMed Full text at PMC Publisher
In one paragraph

Guideline in Neurology, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 4 registered trials, which are not on this map. Cited by 80 papers, 10 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
80citing papers in PubMed, 10 pooled it
13.5field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT02369770 narecruitingnot on this mapstarted 2019, after this paper: background citation

Sensory-Motor Rehabilitation Post Stroke

TypeinterventionalSponsorUniversity of Maryland, BaltimoreRan2019 to 2027Enrolled140ConditionsAcute StrokeArmsstretching and active movement training
NCT05702606 nacompletednot on this mapstarted 2021, after this paper: background citation

Radial Extracorporeal Shock Wave Therapy for Management of Spasticity in Patients With Cerebral Palsy

TypeinterventionalSponsorFundacio Aspace CatalunyaRan2021 to 2022Enrolled73ConditionsCerebral Palsy, Spasticity, Muscle, Extracorporeal Shock Wave TherapyArmsRadial extracorporeal shock wave therapy (rESWT)
NCT06404268 phase1 / phase2recruitingnot on this mapstarted 2025, after this paper: background citation

Facilitating Neuroplastic Changes of Acute Stroke Survivors With Severe Hemiplegia

TypeinterventionalSponsorUniversity of Maryland, BaltimoreRan2025 to 2028Enrolled68ConditionsStrokeArmsMotor relearning training, Passive stretching, Gamed-based active movement training, Passive movement, Active movement training
NCT06465290 narecruitingnot on this mapstarted 2026, after this paper: background citation

Promoting Neuroplastic Changes of Patients With TBI

TypeinterventionalSponsorUniversity of Maryland, BaltimoreRan2026 to 2030Enrolled100ConditionsTraumatic Brain InjuryArmsMotor relearning training with wearable ankle robot, Passive stretching with wearable ankle robot, Gamed-based active movement training with wearable ankle robot, Passive movement with limited wearable ankle robot, Active movement training with limited wearable ankle robot
3 · Its place in the literature

Who cites it

80 citing papers in PubMed, 10 syntheses or guidelines pooled it, 296 citations in OpenAlex.

  1. Pooled it
  2. The use of DBS in the treatment of childhood cerebral palsy: a systematic review.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2025
    Pooled it
  3. Guideline
  4. Pooled it
  5. Pooled it
  6. Pooled it
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  8. Guideline
  9. Guideline
  10. Pooled it
  11. Trial
  12. Trial
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  15. Trial
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  18. AbobotulinumtoxinA (DysportJournal of child neurology · 2017
    Trial
  19. Trial
  20. Trial

20 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

11 authors at 4 institutions in 2 countries.

Quality Standards Subcommittee of the American Academy of Neurology and the Practice Committee of the Child Neurology SocietyUniversity of Texas Southwestern Medical Center, Dallas, USA.
M R Delgado
D Hirtz
M Aisen
S Ashwal
D L Fehlings
J McLaughlin
L A Morrison
M W Shrader
A Tilton
J Vargus-Adams
American Academy of Neurology · USUniversity of Washington · USHolland Bloorview Kids Rehabilitation Hospital · CALoma Linda University · US

Funding

UW Center on Outcomes Research in Rehabilitation(RMI)U01AR052171 · NIAMS · UNIVERSITY OF WASHINGTON · PI AMTMANN, DAGMAR · 2004 to 2008
$5.0M
Pediatric TBI and DAI: Normal Appearing Brain is Not NormalR01NS054001 · NINDS · LOMA LINDA UNIVERSITY · PI ASHWAL, STEPHEN · 2006 to 2011
$2.4M
Enhancing PROMIS in Pediatric Pain, Rheumatology, and Rehabilitation ResearchU01AR057940 · NIAMS · CINCINNATI CHILDRENS HOSP MED CTR · PI MORGAN, ESI M · 2009 to 2013
$2.3M
Neonatal Brain Ischemia: Neuroimaging as a Basis For Rational Stem Cell TherapyR01NS059770 · NINDS · LOMA LINDA UNIVERSITY · PI ASHWAL, STEPHEN · 2009 to 2012
$1.3M
Pediatric Hemiplegia: Synergistic Treatment using rTMS and CITRC1HD063838 · NICHD · UNIVERSITY OF MINNESOTA · PI CAREY, JAMES R, MCLAUGHLIN, JOHN FRANCIS · 2009 to 2010
$990k
Towards Improved Clinical Trials in Cerebral PalsyK23HD049552 · NICHD · CINCINNATI CHILDRENS HOSP MED CTR · PI VARGUS-ADAMS, JILDA N · 2006 to 2010
$637k
BEST PHARMACEUTICAL FOR CHILDREN ACT /BPCA/ COORDINATING CENTER CENTER-275033351N01HD033351 · NICHD · PREMIER RESEARCH, INC. · PI BROWNSTEIN, BERNARD H · 2003 to 2006
–
NIAMS NIH HHS 1U01 AR52171-01NIAMS NIH HHS U01 AR057940-01NICHD NIH HHS 1RC 1HD063838-01NICHD NIH HHS K23 HD049552NICHD NIH HHS N01-HD-3-3351NINDS NIH HHS 1R01NS059770-01A2NINDS NIH HHS R01 NS054001-01PHS HHS NICHD-2005-13-2
6 · The paper itself

Abstract

objectiveTo evaluate published evidence of efficacy and safety of pharmacologic treatments for childhood spasticity due to cerebral palsy.

methodsA multidisciplinary panel systematically reviewed relevant literature from 1966 to July 2008.

resultsFor localized/segmental spasticity, botulinum toxin type A is established as an effective treatment to reduce spasticity in the upper and lower extremities. There is conflicting evidence regarding functional improvement. Botulinum toxin type A was found to be generally safe in children with cerebral palsy; however, the Food and Drug Administration is presently investigating isolated cases of generalized weakness resulting in poor outcomes. No studies that met criteria are available on the use of phenol, alcohol, or botulinum toxin type B injections. For generalized spasticity, diazepam is probably effective in reducing spasticity, but there are insufficient data on its effect on motor function and its side-effect profile. Tizanidine is possibly effective, but there are insufficient data on its effect on function and its side-effect profile. There were insufficient data on the use of dantrolene, oral baclofen, and intrathecal baclofen, and toxicity was frequently reported. RECOMMENDATIONS: For localized/segmental spasticity that warrants treatment, botulinum toxin type A should be offered as an effective and generally safe treatment (Level A). There are insufficient data to support or refute the use of phenol, alcohol, or botulinum toxin type B (Level U). For generalized spasticity that warrants treatment, diazepam should be considered for short-term treatment, with caution regarding toxicity (Level B), and tizanidine may be considered (Level C). There are insufficient data to support or refute use of dantrolene, oral baclofen, or continuous intrathecal baclofen (Level U).

Indexed as

AdolescentBotulinum Toxins, Type ACerebral PalsyChildClonidineDiazepamHumansMuscle Relaxants, CentralMuscle SpasticityNeuromuscular AgentsTreatment OutcomeBotulinum Toxins, Type AClonidineDiazepamMuscle Relaxants, CentralNeuromuscular Agentstizanidine

Identifiers

PMID20101040
PMCPMC3122302
OpenAlexW2153517850

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.