SynthesisAmerican journal of physical medicine & rehabilitation2025
Limited Evidence of Functional Benefit After Upper Limb Botulinum Toxin Treatment in Children With Cerebral Palsy: Systematic Review and Meta-analysis.
Synthesis in American journal of physical medicine & rehabilitation, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.
What it found
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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.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
4 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Efficacy of botulinum toxin type A for spasticity management and motor function in children with cerebral palsy: a systematic review and meta-analysis of randomized controlled trials.Frontiers in neurologyPooled it
- Botulinum Toxin in Children and Adolescents-A Comprehensive Review of Clinical Applications.Toxins · 2026Review
- Long-term functional decline following upper limb botulinum toxin injections in children with unilateral cerebral palsy: A preliminary retrospective 5-year follow-up case-control study.Journal of children's orthopaedics · 2026Article
- A novel contralateral ulnar nerve transfer model for selective muscle reinnervation in upper motor neuron syndrome.Neural regeneration research · 2026Article
Corrections and comments
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesThis systematic review and meta-analysis of randomized controlled trials aimed to summarize the reported functional effects of upper limb botulinum toxin treatment in children with spastic cerebral palsy.
designSix databases were searched in October 2022. Two independent authors screened and extracted data on upper limb function, body function, life quality, muscle tone, spasticity, goals, pain, adverse events, and client satisfaction. A random effect model meta-analysis was performed, and RoB 2 and GRADE pro tools were used.
resultsA total of 4862 publications were screened, 14 trials (621 patients) included. Pooled analyses confirm a decrease in muscle tone: mean difference Ashworth scale wrist -0.85 (95% confidence interval = -1.42 to -0.27). No significant functional gain was established: Melbourne Assessment mean difference 3.13 (95% confidence interval = -3.13 to 9.3), and Assisting Hand Assessment mean difference 3.84 (95% confidence interval = -1.86 to 9.54). Botulinum toxin groups had better goal achievement: Goal Attainment Scaling T scores mean difference 9.55 (95% confidence interval = 6.05 to 13.04) and better client satisfaction: improvement had an odds ratio of 8.44 (95% confidence interval = 1.34 to 53.08).
conclusionsResults suggest that upper limb botulinum toxin treatment is effective to decrease muscle tone, but functional benefits are not clearly established. The discrepancy between subjective and objective results requires further investigation.
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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.