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Motor function after selective dorsal rhizotomy: a 10-year practice-based follow-up study.

Authors :
JOSENBY, ANNIKA LUNDKVIST
WAGNER, PHILIPPE
JARNLO, GUN-BRITT
WESTBOM, LENA
NORDMARK, EVA
Source :
Developmental Medicine & Child Neurology. May2012, Vol. 54 Issue 5, p429-435. 7p.
Publication Year :
2012

Abstract

Aim The aim of this study was to explore changes in motor function up to 10 years after selective dorsal rhizotomy (SDR). Method The participants comprised 29 children (20 males, nine females) with bilateral spastic diplegia who were consecutively operated on at a median age of 4 years and 3 months and followed until a median age of 15 years. SDR was combined with physiotherapy and regular follow-up visits. The distribution of preoperative Gross Motor Function Classification System (GMFCS) levels was as follows: I, n=1; II, n=7; III, n=8; IV, n=12; and V, n=1. Muscle tone in hip flexors, hip adductors, knee flexors, and plantar flexors was assessed with the modified Ashworth scale, passive range of motion in hip abduction, popliteal angle, maximum knee extension, dorsiflexion of the foot was measured with a goniometer, and gross motor function was assessed using the Gross Motor Function Measure (GMFM-66). The results were compared with preoperative values, taking into account age at the time of SDR. Results After 10 years, muscle tone in hip flexors, hip adductors, knee flexors and plantar flexors was normalized in 19, 24, 13 and 23 participants respectively; mean change in passive range of motion ranged from −2.0° to 8.6°, and the mean increase in GMFM-66 was 10.6. Changes in GMFM-66 were associated with preoperative GMFCS level and GMFM-66 scores. Interpretation Children who underwent SDR and physiotherapy and were regularly followed up by an experienced team showed improved gross motor function for up to 10 years postoperatively. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
00121622
Volume :
54
Issue :
5
Database :
Academic Search Index
Journal :
Developmental Medicine & Child Neurology
Publication Type :
Academic Journal
Accession number :
74078444
Full Text :
https://doi.org/10.1111/j.1469-8749.2012.04258.x