AIM: Botulinum toxin A injections and orthotics have been used to manage upper extremity spasticity in hemiplegic children. The authors performed a study to evaluate the necessity and effectiveness of a static night splint following outpatient Botulinum toxin A treatment in children with upper limb spastic cerebral palsy. METHODS: Twenty children with upper limb spastic cerebral palsy were treated with Botulinum toxin A injections. A static night splint was applied in half of them. Objective assessment of upper limb function was performed at baseline, at 2 and 6 months after Botulinum toxin A injection using the Quality of Upper Extremity Skills Test. RESULTS: After Botulinum toxin A treatment, both groups showed an improvement on their previous functional level of the injected upper extremity. At 2 months, children in group A showed a 15.4% improvement, whereas children in group B improved by 12.2% from baseline; these were not statistically significant (p = 0.326). At 6 months, group A still maintained a 15.9% improvement in function compared to group B which differed only by 4.2% from pre-Botulinum toxin A baseline; these differences were statistically significant (p = 0.000). Complications related to the Botulinum toxin A injection were not observed. The static night upper-extremity splints have been well tolerated by the hemiplegic children. CONCLUSIONS: Static night splinting following Botulinum toxin A injections has shown a definite treatment effect in reducing spasticity and improving function in children with upper limb spastic cerebral palsy.

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