Three‐year outcomes of repeated botulinum neurotoxin A injections to the lower extremities in young children with spastic cerebral palsy in <scp>GMFCS</scp> levels I to <scp>III</scp>
Bibliographic record
Abstract
Abstract Aim To evaluate the effectiveness of repeated botulinum neurotoxin A (BoNT‐A) injections on gross motor function over 3 years in ambulant children with spastic cerebral palsy (CP). Method A prospective observational cohort study of 124 participants was conducted comparing outcomes in children (aged 2–6 years) with spastic CP functioning in Gross Motor Function Classification System (GMFCS) levels I to III who did and did not receive BoNT‐A. The primary outcome was the 66‐item Gross Motor Function Measure (GMFM‐66), assessed at baseline and annually over 3 years. Secondary outcomes included passive ankle dorsiflexion with knee extended (PADKE) and several measures of activity and participation. Results A total of 117 participants (94%), consisting of 61 cases and 56 comparisons, were assessed on the GMFM‐66 at a follow‐up of 1 year or longer, with 106 (85%) assessed at year 3. There were no significant differences in mean GMFM‐66 scores adjusted for baseline differences between groups over time ( β̂ group = 0.92, standard error [SE] = 0.81, 95% confidence interval [CI] = − 0.66 to 2.50; p = 0.256). A difference in PADKE favouring the comparison group was observed ( β̂ group = − 4.17, SE = 1.58, 95% CI = − 7.27 to − 1.08; p = 0.009), approaching the 5° minimally important difference. Interpretation Repeated BoNT‐A injections over 3 years were not associated with improvements in gross motor function or passive ankle dorsiflexion range in young children with spastic CP functioning in GMFCS levels I to III compared to a comparison group not receiving BoNT‐A.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.002 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".