Comparison of motor outcomes after selective dorsal rhizotomy with and without preoperative intensified physiotherapy in children with spastic diplegic cerebral palsy

Pediatric Neurosurgery
P Steinbok, Kimberley McLeod

Abstract

A previous randomized clinical trial compared selective dorsal rhizotomy (SDR) plus postoperative intensified physiotherapy (group 1) with intensified physiotherapy alone (group 2) for children with spastic diplegic cerebral palsy. At the end of this trial, all patients in group 2 had an SDR, followed by further intensified physiotherapy. This study was performed to determine if the additional intensified physiotherapy before SDR, as occurred in group 2, improved long-term motor outcome. Outcomes were compared in the two groups, i.e. group 1 without intensified physiotherapy before SDR and group 2 with intensified physiotherapy before SDR. The primary outcome measure was the Gross Motor Function Measure (GMFM). Lower-limb spasticity, range and strength were secondary outcome measures. Baseline assessments had been done for the prior clinical trial. For this study, patients were reassessed by physiotherapists blinded to the treatment group. Thirteen children in each group were studied at a mean follow-up of 53 months. The mean improvement in GMFM was 10.0 in group 1 and 10.4 in group 2 (p = 0.9). Improvements in spasticity and range were similar in the two groups. There was no significant change in muscle strength in either grou...Continue Reading

Citations

Jul 27, 2007·Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery·Nobuhito Morota
Nov 3, 2004·Pediatric Neurology·Meredith R GolombLinda S Williams
Jul 29, 2006·Journal of Neurosurgery·Joseph H Piatt
Oct 11, 2013·Developmental Medicine and Child Neurology·Sebastian GruntNelleke G Langerak
Dec 20, 2005·Developmental Medicine and Child Neurology·Vanessa A B ScholtesGustaaf J Lankhorst
Aug 26, 2010·Physical & Occupational Therapy in Pediatrics·Liz MartinAdrienne Harvey
Feb 8, 2018·Revista paulista de pediatria : orgão oficial da Sociedade de Pediatria de São Paulo·Renata D'Agostini Nicolini-PanissonMárcio Vinicius Fagundes Donadio
Jun 3, 2006·Pediatrics·Heidi AnttilaMarjukka Mäkelä

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