Comprehensive instrumented muscle and joint assessments should be considered when prescribing Botulinum NeuroToxin-A (BoNT-A) treatment in spastic paresis. In a child with spastic paresis, comprehensive evaluation following treatment with BoNT-A, serial casting, and physiotherapy showed that short-term improvements in gait occurred without changes in muscle morphology. Rather, foot flexibility increased.
Weide, G., Sloot, L., Oudenhoven, L., Jaspers, R. T., Harlaar, J., Buizer, A., & Bar-On, L. (2019). Comprehensive evaluation of gait, spasticity, and muscle morphology: A case report of a child with spastic paresis treated with Botulinum NeuroToxin-A, serial casting, and physiotherapy. Clinical case reports, 7(9), 1637-1646. https://doi.org/10.1002/ccr3.2227