Postgraduate Profiles

Caroline Alexander

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Thesis: Musculoskeletal properties in children with cerebral palsy: The impact of Botulinum Toxin type A

Cerebral palsy (CP) is a disorder of movement and posture that affects 2.0-2.5 in every 1000 live births. Muscle spasticity and other muscle or bone abnormalities greatly impact the functional ability of children with CP. To reduce muscle spasticity, and improve the functional ability of children, muscle targeted interventions are often used. Such interventions include the drug Botulinum Neurotoxin Type-A (BoNT-A). With consistent evidence for positive clinical outcomes, including reduction in spasticity and improvement in clinical assessments of gross motor function, it is now considered best practice care. However, less is known about the effect of the toxin on other aspects of musculoskeletal properties, including fine muscle structure, gross muscle morphology, muscle-tendon properties and muscle function during gait.

My PhD research systematically assesses musculoskeletal abnormalities in children with CP in relation to BoNT-A treatment. A combination of longitudinal designs and cross sectional studies is employed to provide a comprehensive understanding of the immediate and long term effects of BoNT-A on a range of musculoskeletal abnormalities.

This research is conducted in collaboration with the Paediatric Rehabilitation department at Princess Margaret Hospital, which is the only public provider for Botulinum Toxin in children with CP in Western Australia.

Why my research is important

Every year, approximately 400 children receive BoNT-A injections through PMH. Many of these children receive multiple injections at each time, and can receive injections as often as every 6 months. Enhanced understanding of the impact of BoNT-A on musculoskeletal properties will directly improve the use of the toxin in Western Australia and worldwide through informing the frequency of BoNT-A use, and the use of associated targeted therapy interventions to optimise the positive effect of BoNT-A.

Feb 2013

Feb 2016