Evidence map›Paper›PMID 39058740›Full record

Trial reportDevelopmental medicine and child neurology2025

Does botulinum neurotoxin A make walking easier in children with cerebral palsy? A randomized clinical trial.

Siri Merete Brændvik, Anne Elisabeth Ross Raftemo, Karin Roeleveld, Guro Lillemoen Andersen, Kjersti Ramstad, Turid Follestad, Ånen Aarli, Marcin Bonikowski, Torstein Vik, Walking Easier

Registry-linked trialAbstract readRandomized Controlled TrialMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Developmental medicine and child neurology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02546999 (Does Botulinum Toxin A Make Walking Easier in Children With Cerebral Palsy?), which is not on this map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
–field-weighted citation impact
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.

NCT02546999 phase4completednot on this map

Does Botulinum Toxin A Make Walking Easier in Children With Cerebral Palsy?

TypeinterventionalSponsorSt. Olavs HospitalRan2015 to 2021Enrolled61ConditionsCerebral Palsy, Muscle SpasticityArmsbotox, placebo
3 · Its place in the literature

Who cites it

6 citing papers in PubMed.

  1. Trial
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Siri Merete BrændvikDepartment of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, NTNU, Trondheim, Norway.ORCID 0000-0001-6860-1804
Anne Elisabeth Ross RaftemoVestfold Hospital Trust, Tønsberg, Norway.
Karin RoeleveldDepartment of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, NTNU, Trondheim, Norway.
Guro Lillemoen AndersenVestfold Hospital Trust, Tønsberg, Norway.
Kjersti RamstadOslo University Hospital, Oslo, Norway.
Turid FollestadDepartment of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, NTNU, Trondheim, Norway.
Ånen AarliHaukeland University Hospital, Bergen, Norway.
Marcin BonikowskiMazovian Neuropsychiatry Center, Neuro Rehabilitation Department, Movement Analysis Laboratory, Poland.
Torstein VikDepartment of Laboratory Medicine, Children's and Women's Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, NTNU, Trondheim, Norway.
Walking Easier

Funding

Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology Post doc position in the studyRegional Health Authorities in Norway 230435
6 · The paper itself

Abstract

aimTo assess the effect of single botulinum neurotoxin A (BoNT-A) injections into the calf muscles on the gross energy cost of walking in children with cerebral palsy (CP) and to evaluate the effect of BoNT-A on walking capacity, physical activity, perceived changes in mobility, and pain.

methodThis was an industry-independent, randomized, quadruple-blind, placebo-controlled, multicentre trial (ClinicalTrials.gov registration: NCT02546999). Sixty-one children (33 male, median age [range] = 8 years [4-16 years]) with spastic CP and classified in Gross Motor Function Classification System (GMFCS) levels I and II allocated to single injections of either BoNT-A or 0.9% saline into the calf muscles. The main outcome was gross energy cost (J/kg/m); secondary outcomes were walking capacity, habitual physical activity, perceived change in mobility tasks, and calf pain at baseline, 4 weeks (P1), 12 weeks (P2), and 24 weeks (P3) after the injection.

resultsThe mean change in energy cost did not differ significantly between groups at the primary time point P2 (-0.27 J/kg/m, 95% confidence interval - 0.91 to 0.36, p = 0.404), nor at P1 or P3. Regarding the secondary outcomes, there was some evidence of a larger reduction in pain intensity in the group given BoNT-A (p = 0.043).

interpretationOne treatment with BoNT-A was not superior to placebo in making walking easier in children with CP classified in GMFCS levels I and II, at least in the short term. BoNT-A may have a pain-reducing effect.

Indexed as

Botulinum Toxins, Type ACerebral PalsyNeuromuscular AgentsWalkingAdolescentChildChild, PreschoolEnergy MetabolismFemaleHumansMaleMuscle, SkeletalTreatment OutcomeBotulinum Toxins, Type ANeuromuscular Agents

Identifiers

PMID39058740
PMCPMC11695802

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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.