Quantification of long-term effects of botulinum injection in a case of cerebral palsy affecting the upper limb movement

Objective: The aim of this work was to put into evidence the long-lasting modification induced by botulinum toxin injection and rehabilitative treatment on motor control. Methods: In this contribution, we report the case of a female child showing hemiplegia, due to cerebral palsy. She underwent botulinum injection, followed by physical and occupational therapy. We quantified the biomechanical, cerebral and occupational aspects of her impaired upper limb, also dynamically, with respect to her pre- and post-treatment condition. Results: Small long-lasting improvements-induced on biomechanics by botulinum injection-triggered wide cerebral modification, well reflected in improved contextual movements and motor strategy. Conclusion: These results provide evidences that small modifications in the end-effector performance often imply cerebral modifications and improvement in finalized motor strategy.