"Thumbs up!"

This study looks at whether Botulinum Toxin-A (BTX-A) injections into the small muscles of the thumb — combined with occupational therapy and home exercises — can help children with cerebral palsy use their thumbs better. Cerebral palsy can make the thumb stiff and difficult to move, which affects everyday tasks like gripping objects, hygiene, and wearing splints. The trial compares two groups: one that receives BTX-A injections plus therapy, and one that receives therapy alone. You may be eligible if: - Your child is between 2 and 12 years old - Your child has cerebral palsy - Your child already receives lower limb BTX-A injections under general anaesthetic - Your child weighs more than 10 kg - Your child has stiffness in the thumb muscles that affects function, hygiene, or splint use - You (the parent or guardian) are willing to take part in a home therapy program and clinic appointments - You have provided written informed consent You may NOT be eligible if: - Your child has a known allergy to botulinum toxin A or its ingredients - Your child has myasthenia gravis or a similar nerve-muscle condition - Your child has an active infection at the injection site - Your child takes certain antibiotics or muscle relaxants that interfere with nerve function - Your child has had thumb surgery for spasticity or contracture - Your child received BTX-A to the upper limb within the last 6 months - Your child uses the thumb stiffness as part of how they grip or function Talk to your doctor about whether this trial might be right for you.