Quality of life after selective dorsal rhizotomy: an assessment of family-reported outcomes using the CPQoL questionnaire

2020 ◽  
Vol 36 (9) ◽  
pp. 1977-1983
Author(s):  
James M. W. Robins ◽  
Abbey Boyle ◽  
Kate McCune ◽  
Rajib Lodh ◽  
John R. Goodden
Keyword(s):  
Quality Of Life ◽  
Selective Dorsal Rhizotomy ◽  
Dorsal Rhizotomy

A review of orthopedic surgeries after selective dorsal rhizotomy

2006 ◽  
Vol 21 (2) ◽  
pp. E2 ◽  
Author(s):  
Donncha F. O'Brien ◽  
Tae Sung Park
Keyword(s):  
Quality Of Life ◽  
Cerebral Palsy ◽  
Orthopedic Surgery ◽  
Young Age ◽  
Evidence Based ◽  
Selective Dorsal Rhizotomy ◽  
Evidence Based Treatment ◽  
Dorsal Rhizotomy ◽  
Historical Controls

✓ Selective dorsal rhizotomy (SDR) is an evidence-based treatment for cerebral palsy (CP) spasticity. During their lifetime, patients with CP spasticity may require orthopedic surgery for muscles and joints to correct physical deformities and provide a better quality of life. In this review, the authors discuss the timing of such orthopedic surgery, its necessity, and whether it is influenced by the performance of SDR. A review of findings from the authors' 19 years of experience yields the following conclusions: 1) that SDR reduces orthopedic surgery requirements when compared with historical controls; 2) that SDR performed in patients at a young age (2–4 years) can reduce future orthopedic surgery requirements; 3) that independent walkers and diplegic patients will have the smallest amount of orthopedic surgery post-SDR; and 4) that patients who need assistance walking and those with quadriplegia will have the greatest amount, although the frequency of orthopedic surgery for quadriplegic patients is not as high as popularly believed.

P 1175. Increased Quality of Life in Children with Cerebral Palsy after Selective Dorsal Rhizotomy

2018 ◽  
Author(s):  
Elisa Wittmack ◽  
Franziska Hentschel ◽  
Akosua Sarpong-Bengelsdorf ◽  
Julia Funk ◽  
Antje Niemeyer ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Cerebral Palsy ◽  
Selective Dorsal Rhizotomy ◽  
Dorsal Rhizotomy ◽  
Children With Cerebral Palsy

Selective dorsal rhizotomy in children with spastic hemiparesis

2010 ◽  
Vol 6 (4) ◽  
pp. 353-358 ◽  
Author(s):  
Allison Oki ◽  
Wende Oberg ◽  
Beth Siebert ◽  
Dutch Plante ◽  
Marion L. Walker ◽  
...  
Keyword(s):  
Stride Length ◽  
The Other ◽  
Assessment Scale ◽  
Selective Dorsal Rhizotomy ◽  
Dorsal Rhizotomy ◽  
Spastic Hemiparesis ◽  
Gait Assessment ◽  
Modified Ashworth Scale ◽  
Ashworth Scale

Object Neurological conditions including cerebral palsy, brain injury, and stroke often result in severe spasticity, which can lead to significant deformity and interfere with function. Treatments for spasticity include oral medications, intramuscular botulinum toxin type A injections, orthopedic surgeries, intrathecal baclofen pump implantation, and selective dorsal rhizotomy (SDR). Selective dorsal rhizotomy, which has been well studied in children with spastic diplegia, results in significant reduction in spasticity and improved function in children. To the authors' knowledge, there are no published outcome data for SDR in patients with spastic hemiparesis. The object of this study was to examine the effects of SDR on spastic hemiparesis. Methods A 2-year study was undertaken including all children with spastic hemiparesis who underwent SDR at the authors' institution. The degree of spasticity, as measured by the Modified Ashworth Scale or quality of gait rated using the visual gait assessment scale, the gait parameters, and velocity were compared in patients before and after undergoing SDR. Results Thirteen children (mean age 6 years 7 months) with spastic hemiparesis underwent SDR performed by the same surgeon during a 2-year period. All of the patients had a decrease in tone in the affected lower extremity after the procedure. The mean reduction in tone in 4 muscle groups (hip adductors, knee flexors, knee extensors, and ankle plantar flexors) according to the modified Ashworth scale score was 2.6 ± 1.26 (p < 0.0001). The quality of gait was assessed in 7 patients by using the visual gait assessment scale. This score improved in 6 patients and remained the same in 1. Stride length and gait velocity were measured in 4 children. Velocity increased in 3 patients and decreased in a 3-year-old child. Parents and clinicians reported an improvement in quality of gait after the procedure. Stride length increased bilaterally in 3 patients and increased on one side and decreased on the other in the other patient. Conclusions Selective dorsal rhizotomy showed efficacy in the treatment of spastic hemiparesis in children. All of the patients had decreased tone after SDR as measured by the modified Ashworth scale. The majority of patients had qualitative and quantitative improvements in gait.

scholarly journals “Fulfilling the chief of his duties as a physician”: Harvey Cushing, selective dorsal rhizotomy and elective spine surgery for quality of life

2011 ◽  
Vol 14 (3) ◽  
pp. 421-427 ◽  
Author(s):  
Hormuzdiyar H. Dasenbrock ◽  
Courtney Pendleton ◽  
Matthew J. McGirt ◽  
Daniel M. Sciubba ◽  
Ziya L. Gokaslan ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Spinous Process ◽  
Symptomatic Improvement ◽  
Radicular Pain ◽  
Dorsal Rhizotomy ◽  
Harvey Cushing ◽  
Tabes Dorsalis ◽  
Postoperative Improvement

At the beginning of the 20th century, the development of safer anesthesia, antiseptic techniques, and meticulous surgical dissection led to a substantial decrease in operative risk. In turn, the scope of surgery expanded to include elective procedures performed with the intention of improving the quality of life of patients. Between 1908 and 1912, Harvey Cushing performed 3 dorsal rhizotomies to improve the quality of life of 3 patients with debilitating neuralgia: a 54-year-old man with “lightning” radicular pain from tabes dorsalis, a 12-year-old boy cutaneous hyperesthesia and spasticity in his hemiplegic arm, and a 61-year-old man with postamputation neuropathic pain. Symptomatic improvement was seen postoperatively in the first 2 cases, although the third patient continued to have severe pain. Cushing also removed a prominent spinous process from each of 2 patients with debilitating headaches; both patients, however, experienced only minimal postoperative improvement. These cases, which have not been previously published, highlight Cushing's views on the role of surgery and illustrate the broader movement that occurred in surgery at the time, whereby elective procedures for quality of life became performed and accepted.

More than 25 years after selective dorsal rhizotomy: physical status, quality of life, and levels of anxiety and depression in adults with cerebral palsy

2021 ◽  
pp. 1-10
Author(s):  
Berendina E. Veerbeek ◽  
Robert P. Lamberts ◽  
Elisa Kosel ◽  
A. Graham Fieggen ◽  
Nelleke G. Langerak
Keyword(s):  
Muscle Strength ◽  
Muscle Tone ◽  
Functional Mobility ◽  
Anxiety And Depression ◽  
Physical Status ◽  
Selective Dorsal Rhizotomy ◽  
Dorsal Rhizotomy ◽  
Lower Extremity Muscle ◽  
Sf 36

OBJECTIVE The primary purpose of selective dorsal rhizotomy (SDR) is to ameliorate spasticity in the lower extremities of children with cerebral palsy (CP). In correctly selected patients, this neurosurgical procedure has been shown to have a beneficial effect on many aspects of the child’s life. However, given the challenges faced by adults with CP, it would be valuable to document the status of this population compared to their peers later in adulthood. Therefore, the aim of this study was to determine the physical status, mental health, and health-related quality of life (HRQoL) of adults with CP who underwent SDR at least 25 years ago, compared to matched typically developing (TD) individuals. The second aim was to investigate relationships between physical status and the other outcome measures. METHODS Adults with CP were recruited from a database of children who had undergone SDR performed using the technique introduced by Professor Warwick Peacock at Red Cross War Memorial Children’s Hospital in Cape Town, South Africa, between 1981 and 1991. These individuals were matched for age, sex, body mass index, and socioeconomic status to a TD adult cohort from a similar background. The parameters assessed were lower-extremity muscle tone, passive range of motion, muscle strength, selectivity, functional mobility and dynamic balance (Timed Up and Go [TUG] test), HRQoL (SF-36), and anxiety and depression levels. RESULTS Twenty-six adults with CP who had a median age of 35.8 years (interquartile range 34.2–41.4 years) (female/male: n = 10/16; Gross Motor Function Classification System level I/II/III: n = 13/10/3), were compared to 26 TD adults. Muscle tone was similar, whereas passive range of motion, muscle strength, selectivity, TUG, and SF-36 physical functioning (concept and summary) scores differed between the cohorts. Other SF-36 parameters, anxiety levels, and depression levels were not different. Strong correlations were found between the muscle strength and TUG scores. CONCLUSIONS Normalized lower-extremity muscle tone was sustained 25–35 years after SDR. Whereas the lower scores for physical assessments are in line with findings in other CP populations, remarkably, relatively good mental health and HRQoL scores were reported in this CP group despite their physical limitations. The strong correlation between muscle strength and TUG suggests that strength training after SDR may have value in improving functional mobility and balance.

An experimental study of reflex variability in selective dorsal rhizotomy

1994 ◽  
Vol 81 (6) ◽  
pp. 885-894 ◽  
Author(s):  
Arnold D. C. Rivera ◽  
Tim Burke ◽  
Steven J. Schiff ◽  
Ira P. Weiss
Keyword(s):  
Measurement Techniques ◽  
Constant Current ◽  
Threshold Estimation ◽  
Selective Dorsal Rhizotomy ◽  
Content Type ◽  
Dorsal Rhizotomy ◽  
Before And After ◽  
Constant Current Stimulation ◽  
Reflex Threshold

✓ Significant problems regarding the measurement technique currently used to choose nerve roots for sectioning in the selective dorsal rhizotomy procedure have recently been reported. To better understand the source of these problems, a series of six experiments was performed in which the selective rhizotomy technique was applied to cats that were either intact, decerebrate, or spinalized. Measurements were made before and after partial rhizotomy. In decerebrate preparations, large, spontaneous changes in reflex threshold were observed over short periods of time, especially after partial rhizotomy was performed, and threshold changes greater than 1000% could be observed over 10-minute periods. Using constant-current stimulation of the dorsal root at threshold, the response of each ipsilateral leg muscle demonstrated frequent changes, and changes coincided with the variability in threshold estimation. In addition, very low thresholds were measured (0.1 to 0.25 mA) in half (3 of 6) of these experiments, these measurements being well below the currents customarily used for intraoperative decision making. Stimulation at twice threshold was found to consistently increase the pathological quality of the responses observed. Although intact animals never displayed contralateral responses when stimulated at threshold, such contralateral responses could readily be elicited at twice threshold. These laboratory results raise further doubts regarding the reliability of the measurement techniques now widely used for selective dorsal rhizotomy.

Self-Compassion and Quality of Life in Adults Who Stutter

2020 ◽  
Vol 29 (4) ◽  
pp. 2097-2108
Author(s):  
Robyn L. Croft ◽  
Courtney T. Byrd
Keyword(s):  
Quality Of Life ◽  
Social Connectedness ◽  
The Self ◽  
Future Research ◽  
Self Compassion ◽  
Adults Who Stutter ◽  
And Gender ◽  
Relationship Of ◽  
The Impact

Purpose The purpose of this study was to identify levels of self-compassion in adults who do and do not stutter and to determine whether self-compassion predicts the impact of stuttering on quality of life in adults who stutter. Method Participants included 140 adults who do and do not stutter matched for age and gender. All participants completed the Self-Compassion Scale. Adults who stutter also completed the Overall Assessment of the Speaker's Experience of Stuttering. Data were analyzed for self-compassion differences between and within adults who do and do not stutter and to predict self-compassion on quality of life in adults who stutter. Results Adults who do and do not stutter exhibited no significant differences in total self-compassion, regardless of participant gender. A simple linear regression of the total self-compassion score and total Overall Assessment of the Speaker's Experience of Stuttering score showed a significant, negative linear relationship of self-compassion predicting the impact of stuttering on quality of life. Conclusions Data suggest that higher levels of self-kindness, mindfulness, and social connectedness (i.e., self-compassion) are related to reduced negative reactions to stuttering, an increased participation in daily communication situations, and an improved overall quality of life. Future research should replicate current findings and identify moderators of the self-compassion–quality of life relationship.

Misophonia: An Evidence-Based Case Report

2020 ◽  
Vol 29 (4) ◽  
pp. 685-690
Author(s):  
C. S. Vanaja ◽  
Miriam Soni Abigail
Keyword(s):  
Quality Of Life ◽  
Case Report ◽  
Case History ◽  
Pure Tone ◽  
Physiological Responses ◽  
Evidence Based ◽  
Management Option ◽  
Pure Tone Audiogram

Purpose Misophonia is a sound tolerance disorder condition in certain sounds that trigger intense emotional or physiological responses. While some persons may experience misophonia, a few patients suffer from misophonia. However, there is a dearth of literature on audiological assessment and management of persons with misophonia. The purpose of this report is to discuss the assessment of misophonia and highlight the management option that helped a patient with misophonia. Method A case study of a 26-year-old woman with the complaint of decreased tolerance to specific sounds affecting quality of life is reported. Audiological assessment differentiated misophonia from hyperacusis. Management included retraining counseling as well as desensitization and habituation therapy based on the principles described by P. J. Jastreboff and Jastreboff (2014). A misophonia questionnaire was administered at regular intervals to monitor the effectiveness of therapy. Results A detailed case history and audiological evaluations including pure-tone audiogram and Johnson Hyperacusis Index revealed the presence of misophonia. The patient benefitted from intervention, and the scores of the misophonia questionnaire indicated a decrease in the severity of the problem. Conclusions It is important to differentially diagnose misophonia and hyperacusis in persons with sound tolerance disorders. Retraining counseling as well as desensitization and habituation therapy can help patients who suffer from misophonia.

Quality of Life of Youth With Hearing Loss

ASHA Leader ◽  
2010 ◽  
Vol 15 (15) ◽  
pp. 5-6
Author(s):  
Anne Skalicky ◽  
Brenda Schick ◽  
Donald Patrick
Keyword(s):  
Quality Of Life ◽  
Hearing Loss
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