Article

AIM: To explore the evolution of self-care and functional mobility after
multilevel surgery in children and adolescents with spastic diplegic cerebral
palsy and to identify factors affecting these outcomes. METHOD: Thirty-four
participants (22 males, 12 females) were evaluated before surgery, and at 2
months, 6 months, 1 year, 18 months, and 2 years after surgery. Self-care was
assessed with the Pediatric Evaluation of Disability Inventory Dutch edition. The
Mobility Questionnaire47 (MobQues47) and Functional Mobility Scale (FMS) were
used to measure functional mobility. RESULTS: All outcomes revealed a significant
decrease 2 months after single-event multilevel surgery (SEMLS) (p-value between
<0.001 and 0.02) followed by a significant increase at 6 months (p<0.001 and
p=0.045). Between 6 months and 1 year, a significant increase was also revealed
for Mobques47 (p<0.001), FMS (p</=0.008), and the Pediatric Evaluation of
Disability Inventory Functional Skills Scale (PEDI-FSS) (p=0.001). Improvement
continued until 18 months for the PEDI-FSS. Initial score, initial muscle
strength, Gross Motor Function Classification System level, age, and number of
surgical interventions significantly influenced time trends for self-care and/or
functional mobility. INTERPRETATION: Most preoperative scores are regained at 6
months after SEMLS. Further improvement is seen until 18 months. Participants
with a higher functional level before surgery will temporarily lose more than
participants with lower initial functional ability, but they also fast regain
their function.
Self-care and functional mobility decrease
significantly in the first months after single-event multilevel surgery (SEMLS).
Six months after SEMLS most preoperative scores are regained. Impact of SEMLS is
more pronounced for functional mobility than for self-care. Muscle strength and
functionality at baseline are important influencing factors on the evolution after SEMLS.
CI - (c) 2018 Mac Keith Press.

Langue : ANGLAIS