This resource from the Developmental Medicine and Child Neurology (DMCN) journal, explores whether botulinum toxin type A (BoNT-A) injections can improve walking efficiency in ambulant children with cerebral palsy (CP).

In ambulant children with cerebral palsy (CP), improving walking efficiency is a key clinical goal, as higher energy cost can limit participation and endurance in daily activities. Botulinum toxin type A (BoNT-A) is widely used to reduce lower-limb spasticity, particularly in the calf muscles, with the expectation that this may translate into easier and more efficient walking. However, evidence for its functional benefits, especially on energy cost, remains inconsistent. This multicentre, placebo-controlled trial investigates whether a single BoNT-A injection improves walking efficiency, while also evaluating effects on walking capacity, habitual physical activity, perceived mobility, and pain over short-term follow-up.