Evidence map›Paper›PMID 41042504›Full record

Observational studyDevelopmental medicine and child neurology2026

Three-year outcomes of repeated botulinum neurotoxin A injections to the lower extremities in young children with spastic cerebral palsy in GMFCS levels I to III.

Darcy Fehlings, Emma Bohn, Lauren Switzer, Charles H Goldsmith, Unni Narayanan, Peter L Rosenbaum, F Virginia Wright, Gary Foster, CP‐BoNT‐A Study Group

Abstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Developmental medicine and child neurology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing 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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Review
  2. Observational
  3. Article
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

9 authors.

Darcy FehlingsDepartment of Paediatrics, Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Faculty of Medicine, University of Toronto, Toronto, ON, Canada.ORCID 0000-0003-2680-1028
Emma BohnBloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada.ORCID 0000-0001-7966-0228
Lauren SwitzerBloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada.
Charles H GoldsmithDepartment of Health Research Methods, Evidence and Impact, Faculty of Health Sciences, McMaster University, Hamiton, ON, Canada.
Unni NarayananDepartment of Surgery, University of Toronto, The Hospital for Sick Children, Toronto, ON, Canada.ORCID 0000-0003-0051-9622
Peter L RosenbaumCanChild Centre for Childhood-Onset Disability, Department of Pediatrics, McMaster University, Hamilton, ON, Canada.ORCID 0000-0001-6751-5613
F Virginia WrightDepartment of Physical Therapy, Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, University of Toronto, Toronto, ON, Canada.ORCID 0000-0002-9713-4536
Gary FosterSt Joseph's Healthcare, McMaster University, Hamilton, ON, Canada.
CP‐BoNT‐A Study Group

Funding

Canadian Institute of Health Research, Institute of Human Development, Child and Youth Health 86732
6 · The paper itself

Abstract

aimTo evaluate the effectiveness of repeated botulinum neurotoxin A (BoNT-A) injections on gross motor function over 3 years in ambulant children with spastic cerebral palsy (CP).

methodA prospective observational cohort study of 124 participants was conducted comparing outcomes in children (aged 2-6 years) with spastic CP functioning in Gross Motor Function Classification System (GMFCS) levels I to III who did and did not receive BoNT-A. The primary outcome was the 66-item Gross Motor Function Measure (GMFM-66), assessed at baseline and annually over 3 years. Secondary outcomes included passive ankle dorsiflexion with knee extended (PADKE) and several measures of activity and participation.

resultsA total of 117 participants (94%), consisting of 61 cases and 56 comparisons, were assessed on the GMFM-66 at a follow-up of 1 year or longer, with 106 (85%) assessed at year 3. There were no significant differences in mean GMFM-66 scores adjusted for baseline differences between groups over time (β̂

interpretationRepeated BoNT-A injections over 3 years were not associated with improvements in gross motor function or passive ankle dorsiflexion range in young children with spastic CP functioning in GMFCS levels I to III compared to a comparison group not receiving BoNT-A.

Indexed as

Botulinum Toxins, Type ACerebral PalsyLower ExtremityNeuromuscular AgentsOutcome Assessment, Health CareChildChild, PreschoolFemaleFollow-Up StudiesHumansMaleProspective StudiesSeverity of Illness IndexTreatment OutcomeBotulinum Toxins, Type ANeuromuscular Agents

Identifiers

PMID41042504
PMCPMC13160391

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Registered trials

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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.