Therapeutics
Baljinnyam Avirmed, PhD
Professor, MD
Mongolian National University of Medical Sciences
ulaanbaatar, Ulaanbaatar, Mongolia
Narantsetseg Tsegmid, PhD
Lecturer, MD
Mongolian National University of Medical Sciences
ulaanbaatar, Ulaanbaatar, Mongolia
Batchimeg Shirmen, PhD
MD, Head, Department of Rehabilitation Medicine
Mongolian National University of Medical Sciences
ulaanbaatar, Ulaanbaatar, Mongolia
Davaasuren Ganbold, MS
lecturer
Mongolian National University of Medical Sciences
ulaanbaatar, Ulaanbaatar, Mongolia
gerelmaa zagd, PhD
Professor, MD
Mongolian National University of Medical Sciences
ulaanbaatar, Ulaanbaatar, Mongolia
nyamdavaa Uugandavaa, MS
Lecturer,
Mongolian National University of Medical Sciences
ulaanbaatar, Ulaanbaatar, Mongolia
In Mongolia, no studies have been conducted yet on the use of BoNT-A injections and the ICF to assess outcomes. So our research objective is to assess the health status and health-related conditions of children with cerebral palsy using the ICF framework and to evaluate the effectiveness of comprehensive rehabilitation spasticity management.
Design:
The study involved 98 children aged between 2–18 with spastic cerebral palsy who received care at the Mongolian-Japanese Hospital of the MNUMS between 2018 and 2022. Using the ICF model, a cross-sectional design was used to evaluate. In a clinical trial setting, 80 children aged 2–12 years were divided into two groups to compare the outcomes of comprehensive spasticity rehabilitation management and the BoNT-A injection with intermittent and continuous treatment intervals.
Results:
Out of the 98 children we assessed based on the ICF’s indicators of body function and structure, 38,8% had mild visual impairments, while severe impairments were observed in muscle tone for 68 (69.4%), mobility of joint function for 53 (54.1%), and control of voluntary movement functions for 32 children (32.7%) (p< 0.001). Post hoc analysis revealed a significant reduction in spasticity at 1- and 3-month post-injection in both treatment groups compared to pre-injection levels (p< 0.001). Linear regression analysis demonstrated that the continuous treatment group (Group B) showed significantly better outcomes in motor function compared to the intermittent group (Group A), with a β coefficient of 0.451 (95% CI: 0.209–0.694, p< 0.001).
Conclusion:
Children with CP had severe to complete impairments in muscle tone, joint mobility, and voluntary movement control as well as walking ability (p< 0.001). Environments with poor accessibility negatively affected by 3.27-8.23 times (p< 0.0001). Using the comprehensive rehabilitation management of muscle spasticity in a continuous regimen is more effective in improving mobility and reducing muscle spasticity (β coefficient=0.451, p< 0.001).
