Article

AIM: To explore changes in performance in daily activities (self-care and
mobility) 10 years after selective dorsal rhizotomy (SDR). METHOD: Twenty-four
children with bilateral spastic cerebral palsy were followed; the median age at
SDR was 4 years 1 month (range 2y 5mo-6y 4mo) and at 10-year follow-up was 14
years 6 months (range 12y 3mo-16y 9mo). The preoperative Gross Motor Function
Classification System (GMFCS) levels were: I (n=1), II (n=7), III (n=4), IV
(n=11), and V (n=1). The Pediatric Evaluation of Disability Inventory (PEDI) was
used to assess performance in functional skills, caregiver assistance, and
frequency of modifications and adaptive equipment (MAE) in self-care and mobility
domains. Changes were analysed in relation to preoperative GMFCS levels, PEDI
scores, and age at operation. RESULTS: All scores improved significantly (p<0.01)
during the first 5 years in patients assigned to GMFCS levels I-III and IV-V.
Between 5 years and 10 years, changes were seen in patients grouped in GMFCS
levels I-III in the functional skills, mobility (p=0.04), caregiver assistance
self-care (p=0.03), and caregiver assistance mobility (p=0.03) domains. Those
grouped in GMFCS levels IV-V showed small changes between 5 years and 10 years
after surgery. Changes were dependent on the preoperative GMFCS levels in all
domains; caregiver assistance, self-care and mobility changes were dependent on
preoperative values. The use of MAE increased in participants in GMFCS levels
IV-V. INTERPRETATION: Children who underwent SDR and physiotherapy improved in
functional performance in self-care and mobility and were more independent 10
years postoperatively.
CI - (c) 2014 Mac Keith Press.

Langue : ANGLAIS