Article

OBJECTIVE: To compare the impact of common surgical interventions (selective
dorsal rhizotomy, muscle-tendon surgery, and osteotomies) for patients with
cerebral palsy (CP) on Gross Motor Function Measure and temporal, kinematic, and
kinetic gait variables as assessed via 3-dimensional motion analysis. DESIGN: Retrospective cohort study. SETTING: Motion analyses laboratory. PARTICIPANTS:
Ninety-four patients with CP, 56 of whom underwent surgery (37, muscle-tendon
surgery; 11, osteotomy; and 8, selective dorsal rhizotomy) and 38 of whom did not
have surgery; the patients were ages 4-18 years, with a Gross Motor Function
Classification System classification of I, II, or III. INTERVENTIONS:
Single-event, multilevel muscle tendon surgery, selective dorsal rhizotomy, and
osteotomy. MAIN OUTCOME MEASURES: Change scores (postintervention -
preintervention) in Gross Motor Function Measure and temporal, kinematic, and
kinetic gait variables. RESULTS: No statistically significant differences in
change scores were found between groups in the Gross Motor Function Measure,
velocity, or stride length measures after the observation period. The selective
dorsal rhizotomy group had greater improvements in knee extension when compared
with the nonsurgical group and greater hip and knee total range of motion during
the gait cycle when compared with nonsurgical group and the muscle-tendon surgery
and osteotomy cohorts. Lastly, the muscle-tendon surgery group had greater
improvements in total knee range of motion compared with the nonsurgical group.
CONCLUSIONS: Patients who undergo selective dorsal rhizotomy and, to a lesser
extent, muscle tendon procedures demonstrate greater improvements in kinematic
gait variables compared with nonsurgical interventions in patients with
spasticity resulting from CP.
CI - Copyright (c) 2015 American Academy of Physical Medicine and Rehabilitation.
Published by Elsevier Inc. All rights reserved.

Langue : ANGLAIS