McFall, J and Stewart, C and Kidgell, V and Postans, N and Jarvis, S and Freeman, R and Roberts, A (2015) Changes in gait which occur before and during the adolescent growth spurt in children treated by selective dorsal rhizotomy. Gait and Posture, 42 (3). 317 - 322. ISSN 1879-2219

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Abstract

This paper presents long term follow up results from 17 children (6 girls, 11 boys, GMFCS levels II-IV), treated by means of selective dorsal rhizotomy (SDR). The particular focus is on the effect of the adolescent growth spurt on patients who had previously undergone SDR. The children were all assessed using 3D gait analysis, in combination with clinical examination at three time points-before SDR surgery (PRE), after SDR surgery when pre-adolescent (POST1) and post-adolescence (POST2). The total follow up period to POST2 was 8 years 6 months for girls and 9 years 5 months for boys. All children maintained or improved their GMFCS level. Positive changes in ranges of motion and gait were observed at POST1 and these were generally maintained over adolescence to POST2. The mean Gait Profile Score (GPS) had improved by 3.2 points (14.7-11.5) at POST1, with a non-significant deterioration of 0.3 over the adolescent growth spurt. These positive results reflect the total package of care for the children, involving careful pre-operative selection by a multidisciplinary team and post-operative management including intensive physiotherapy and maintenance in tuned ankle foot orthoses. Fifty-nine per cent of children had some additional orthopaedic surgery, mostly bony procedures. The overall benefits arising from their management need to be considered in the light of the likely deterioration experienced by this patient group. The results of this study support the use of SDR as part of a management strategy for carefully selected children with cerebral palsy with the aim of optimizing gait at skeletal maturity.

Item Type: Article
Uncontrolled Keywords: Cerebral palsy; Selective dorsal rhizotomy; Gait; Adolescence
Subjects: ?? Adolescence ??
?? Adolescent ??
?? Adolescent Development ??
?? Cerebral Palsy ??
?? Cerebral palsy ??
?? Child ??
?? Child, Preschool ??
?? Female ??
?? Follow-Up Studies ??
?? Gait ??
?? Humans ??
?? Male ??
R Medicine > R Medicine (General)
R Medicine > RC Internal medicine > RC925 Diseases of the musculoskeletal system
R Medicine > RJ Pediatrics
?? Rhizotomy ??
?? Selective dorsal rhizotomy ??
?? Treatment Outcome ??
Divisions: Faculty of Medicine and Health Sciences > Institute for Science and Technology in Medicine
Related URLs:
Depositing User: Symplectic
Date Deposited: 11 May 2017 10:37
Last Modified: 11 May 2017 10:37
URI: http://eprints.keele.ac.uk/id/eprint/3400

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