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Motor function after selective dorsal rhizotomy: a 10-year practice-based follow-up study.

Lundkvist, Annika LU orcid ; Wagner, Philippe LU ; Jarnlo, Gun-Britt LU ; Westbom, Lena LU and Nordmark, Eva LU (2012) In Developmental Medicine & Child Neurology 54(5). p.429-435
Abstract
Aim The aim of this study was to explore changes in motor function up to 10 years after selective dorsal rhizotomy (SDR). Method The participants comprised 29 children (20 males, nine females) with bilateral spastic diplegia who were consecutively operated on at a median age of 4 years and 3 months and followed until a median age of 15 years. SDR was combined with physiotherapy and regular follow-up visits. The distribution of preoperative Gross Motor Function Classification System (GMFCS) levels was as follows: I, n=1; II, n=7; III, n=8; IV, n=12; and V, n=1. Muscle tone in hip flexors, hip adductors, knee flexors, and plantar flexors was assessed with the modified Ashworth scale, passive range of motion in hip abduction, popliteal angle,... (More)
Aim The aim of this study was to explore changes in motor function up to 10 years after selective dorsal rhizotomy (SDR). Method The participants comprised 29 children (20 males, nine females) with bilateral spastic diplegia who were consecutively operated on at a median age of 4 years and 3 months and followed until a median age of 15 years. SDR was combined with physiotherapy and regular follow-up visits. The distribution of preoperative Gross Motor Function Classification System (GMFCS) levels was as follows: I, n=1; II, n=7; III, n=8; IV, n=12; and V, n=1. Muscle tone in hip flexors, hip adductors, knee flexors, and plantar flexors was assessed with the modified Ashworth scale, passive range of motion in hip abduction, popliteal angle, maximum knee extension, dorsiflexion of the foot was measured with a goniometer, and gross motor function was assessed using the Gross Motor Function Measure (GMFM-66). The results were compared with preoperative values, taking into account age at the time of SDR. Results After 10 years, muscle tone in hip flexors, hip adductors, knee flexors and plantar flexors was normalized in 19, 24, 13 and 23 participants respectively; mean change in passive range of motion ranged from -2.0° to 8.6°, and the mean increase in GMFM-66 was 10.6. Changes in GMFM-66 were associated with preoperative GMFCS level and GMFM-66 scores. Interpretation Children who underwent SDR and physiotherapy and were regularly followed up by an experienced team showed improved gross motor function for up to 10 years postoperatively. (Less)
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author
; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Developmental Medicine & Child Neurology
volume
54
issue
5
pages
429 - 435
publisher
John Wiley & Sons Inc.
external identifiers
  • wos:000302546100014
  • pmid:22435543
  • scopus:84859485207
  • pmid:22435543
ISSN
0012-1622
DOI
10.1111/j.1469-8749.2012.04258.x
language
English
LU publication?
yes
additional info
The information about affiliations in this record was updated in December 2015. The record was previously connected to the following departments: Department of Orthopaedics (Lund) (013028000), Paediatrics (Lund) (013002000), Division of Nursing (Closed 2012) (013065000), Division of Physiotherapy (Closed 2012) (013042000)
id
ac60697c-070c-4d21-a5af-73dab258adae (old id 2431582)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/22435543?dopt=Abstract
date added to LUP
2016-04-01 10:48:43
date last changed
2023-01-02 08:08:49
@article{ac60697c-070c-4d21-a5af-73dab258adae,
  abstract     = {{Aim The aim of this study was to explore changes in motor function up to 10 years after selective dorsal rhizotomy (SDR). Method The participants comprised 29 children (20 males, nine females) with bilateral spastic diplegia who were consecutively operated on at a median age of 4 years and 3 months and followed until a median age of 15 years. SDR was combined with physiotherapy and regular follow-up visits. The distribution of preoperative Gross Motor Function Classification System (GMFCS) levels was as follows: I, n=1; II, n=7; III, n=8; IV, n=12; and V, n=1. Muscle tone in hip flexors, hip adductors, knee flexors, and plantar flexors was assessed with the modified Ashworth scale, passive range of motion in hip abduction, popliteal angle, maximum knee extension, dorsiflexion of the foot was measured with a goniometer, and gross motor function was assessed using the Gross Motor Function Measure (GMFM-66). The results were compared with preoperative values, taking into account age at the time of SDR. Results After 10 years, muscle tone in hip flexors, hip adductors, knee flexors and plantar flexors was normalized in 19, 24, 13 and 23 participants respectively; mean change in passive range of motion ranged from -2.0° to 8.6°, and the mean increase in GMFM-66 was 10.6. Changes in GMFM-66 were associated with preoperative GMFCS level and GMFM-66 scores. Interpretation Children who underwent SDR and physiotherapy and were regularly followed up by an experienced team showed improved gross motor function for up to 10 years postoperatively.}},
  author       = {{Lundkvist, Annika and Wagner, Philippe and Jarnlo, Gun-Britt and Westbom, Lena and Nordmark, Eva}},
  issn         = {{0012-1622}},
  language     = {{eng}},
  number       = {{5}},
  pages        = {{429--435}},
  publisher    = {{John Wiley & Sons Inc.}},
  series       = {{Developmental Medicine & Child Neurology}},
  title        = {{Motor function after selective dorsal rhizotomy: a 10-year practice-based follow-up study.}},
  url          = {{http://dx.doi.org/10.1111/j.1469-8749.2012.04258.x}},
  doi          = {{10.1111/j.1469-8749.2012.04258.x}},
  volume       = {{54}},
  year         = {{2012}},
}