Journal of Taiwan Occupational Therapy Research and Practice
Context theory posited contextual influences on motor behavior, and Botulinum Toxin (Botox) injection has been applied to treat muscle spasticity for children with cerebral palsy (CP) in rehabilitation. The interplay between Botox injection and contextual influences has not been studied. The purpose of this study was to investigate the influences of context and Botox injection on motor performance for children with CP in forward reaching tasks. Methods: Seventeen children with CP participated in this study and were allocated to different groups by the caregiver's will. The traditional rehabilitation group only received the regular rehabilitation sessions, while the Botox treatment group received the lower limb injection and rehabilitation session. We used clinical measures to evaluate their muscle tone and gross motor function. All participants received two contextual conditions (reality and image) pre- and post-treatment evaluation. Contextual effects were evaluated by kinematic and kinetic analyses, and Botox effects were manifested not only by kinematic and kinetic analyses, but also by clinical assessments. Results: A smoother movement trajectory and a larger peak velocity were found in the imagery-based condition than in the real condition, regardless of groups. There was the enhanced ability of weight bearing at the affected side for the Botox treatment group than for the traditional group, regardless of contextual conditions. Discussion: The findings of this study regarding contextual effects were not consistent with those of previous studies. The reason could be that the task constraints were different from those used in the previous studies. The Botox treatment group improved only in the ability of weight bearing, not in the reaching performance. The treatment program planning may depend on individual needs.