INTRODUCTION: Botulinum toxin (BoNT-A) reduces spasticity and increases the range of motion, functional improvement hence, useful in dynamic spasticity.

OBJECTIVE: To evaluate the efficacy of BoNT-A on spasticity in cerebral palsy (CP) and  assess functional outcome.

METHODS: Children with spastic CP (n=55, 60% male) with a mean age 58±14.51months, received analyzed at baseline, months 3 and 6 using Modified Ashworth scale (MAS) for the evaluation of spasticity. Two components of the Gross Motor Function Measure (GMFM-88):Standing & Walking/Running/Jumping for motor function and functional status with Gross Motor Functional Classification System (GMFCS I-V).

RESULTS: There was a significant (p<0.005) improvement in the assessed components of GMFM-88 at month 3 (Standing 68.3±13.9, Walking/Running/Jumping 63.4±14.3) and month 6 (Standing 70.5± 13.84,

Walking/Running/Jumping 66.4± 14.36) compared to baseline.  Children aged<48 months showed statistically significant improvement in both the dimensions of GMFM-88. MAS of Plantar flexors decreased significantly (p<0.05) at month 3 (Right-1.927±0.87, Left-1.836±1.04) and month 6 (Right-1.618±0.75, Left-1.563±0.91) compared to baseline, but no significant decrease for Hamstrings and Adductors. GMFCS levels significantly (p<0.05) improved for children at levels 2 and 3 at month 3 (Level 2:38.2%,Level 3:29.1%) and month 6(Level 2:43.6%,Level 3:16.4%) compared to baseline.

CONCLUSION: Sustained improvement on functional measures was seen post BoNT-A injection in assessed parameters of GMFM-88 scores for 6 months. Spasticity of Plantar flexors decreased significantly, but not in hamstrings and abductors. Age <48 months, slight to moderate disability, walking with support (GMFCS Levels-III,II) indicated better response.