Functional Status of Patients With Cerebral Palsy According to the International Classification of Functioning, Disability and Health Model: A 20-Year Follow-Up Study After Selective Dorsal Rhizotomy

2009 ◽  
Vol 90 (6) ◽  
pp. 994-1003 ◽  
Author(s):  
Nelleke G. Langerak ◽  
Robert P. Lamberts ◽  
A. Graham Fieggen ◽  
Jonathan C. Peter ◽  
Warwick J. Peacock ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Functional Status ◽  
International Classification Of Functioning ◽  
Disability And Health ◽  
Selective Dorsal Rhizotomy ◽  
Dorsal Rhizotomy ◽  
Follow Up Study ◽  
Health Model

A long-term follow-up study of spinal abnormalities and pain in adults with cerebral palsy and spastic diplegia more than 25 years after selective dorsal rhizotomy

2020 ◽  
pp. 1-8
Author(s):  
Berendina E. Veerbeek ◽  
Robert P. Lamberts ◽  
A. Graham Fieggen ◽  
Ncedile Mankahla ◽  
Richard V. P. de Villiers ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Spastic Diplegia ◽  
Selective Dorsal Rhizotomy ◽  
Dorsal Rhizotomy ◽  
Follow Up Study ◽  
Long Term Follow Up ◽  
Lumbar Hyperlordosis ◽  
Thoracic Hyperkyphosis

OBJECTIVEThe main purpose of selective dorsal rhizotomy (SDR) is to reduce spasticity in the lower extremities of children diagnosed with cerebral palsy (CP) and spastic diplegia. The potential for developing spinal abnormalities and pain is a concern, especially in the aging CP population. Therefore, the aim of this study was to evaluate spinal abnormalities, level of pain, and disability (due to back or leg pain) in adults with CP, and associations with participant characteristics, more than 25 years after SDR.METHODSThis is a 9-year follow-up study with data collection conducted in 2008 and 2017. Radiographs were assessed for the degree of scoliosis, thoracic kyphosis and lumbar lordosis curvatures, and prevalence of spondylolysis and spondylolisthesis, while level of pain and disability was determined with a self-developed questionnaire and the Oswestry Disability Index (ODI) questionnaire, respectively.RESULTSTwenty-five participants were included (15 males; median age 35.9 years, IQR 34.3–41.5 years), with a follow-up time after SDR ranging from 25 to 35 years. No clinically relevant changes were found for spinal curvatures, spondylolysis and spondylolisthesis, perceived pain frequency, and ODI scores between 2008 and 2017. While the prevalence of spondylolysis was 44%, spondylolisthesis was found in 20% (of whom 15% were grade I and 5% grade II), lumbar hyperlordosis was found in 32%, thoracic hyperkyphosis in 4%, and scoliosis in 20%. The Cobb angle was < 25°, and no patient required surgery for scoliosis. In addition, the low back was reported as the most common site of pain, with 28% of the adults with CP having daily pain. This resulted in 80% of the cohort indicating none or minimal disability due to pain based on the ODI. The only correlation found was between hyperkyphosis and female gender.CONCLUSIONSAt follow-up more than 25 years after SDR, no progression in spinal abnormalities, level of pain, and disability was found when compared with findings 15 years after SDR. The prevalence of scoliosis, thoracic hyperkyphosis, and lumbar hyperlordosis was within the range reported for adults with CP, while spondylolysis and spondylolisthesis occurred more often than would be expected. It is difficult, however, to establish the role of SDR in this finding, given the limited data on the natural history of CP. Despite the encouraging outcome of this long-term follow-up study after SDR, it is important to continue monitoring adults with CP during the aging process.

scholarly journals Short-term Gait Parameters Change in Mild Spastic Cerebral Palsy after Selective Dorsal Rhizotomy Guided by Our Newly-Modified Protocol

2021 ◽  
Author(s):  
wenbin jiang ◽  
Shuyun Jiang ◽  
Yan Yu ◽  
Qijia Zhan ◽  
Min Wei ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Lower Limbs ◽  
Spastic Cerebral Palsy ◽  
Selective Dorsal Rhizotomy ◽  
Short Term ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Dorsal Rhizotomy ◽  
Gait Parameters

Abstract Background Selective Dorsal Rhizotomy (SDR) guided by our modified protocol can decrease spasticity in certain muscles. This study aimed to investigate gait parameters changes in cerebral palsy (CP) with focal spasticity after SDR in short-term follow-up. Methods CP classified as Gross Motor Function Classification System (GMFCS) level Ⅰ and Ⅱ who underwent SDR were included. Changes of spasticity, gait parameters and gait deviation index (GDI) were retrospectively reviewed. Results This study contained 26 individuals with 44 affected and 8 intact lower limbs (4 monoplegia, 4 hemiplegia and 18 diplegia). Mean age was 5.7 ± 1.9 years-old and follow-up duration was 9.9 ± 6.6 months. After SDR, average spasticity of 108 target muscles decreased from 2.9 ± 0.8 to 1.8 ± 0.6 in Modified Ashworth Scale (MAS). Kinematic curves changed after the surgery in sagittal and transverse plane in affected sides, further investigation showed improvements in ankle and knee. No changes were found in temporal-spatial parameters except decrease in cadence in affected sides. GDI improved significantly in affected limbs. Conclusion In short-term follow up, the new-protocol-guiding SDR can lower focal spasticity, GA showed improvements in kinematic parameters and GDI. Longer follow-up duration is needed to clarify the long-term outcome.

scholarly journals Selective dorsal rhizotomy for spasticity not associated with cerebral palsy: reconsideration of surgical inclusion criteria

2013 ◽  
Vol 35 (5) ◽  
pp. E6 ◽  
Author(s):  
William C. Gump ◽  
Ian S. Mutchnick ◽  
Thomas M. Moriarty
Keyword(s):  
Cerebral Palsy ◽  
Spinal Cord Injuries ◽  
Spastic Diplegia ◽  
Inclusion Criteria ◽  
Selective Dorsal Rhizotomy ◽  
Dorsal Rhizotomy ◽  
Common Diagnosis

Children with spastic diplegia from cerebral palsy (CP) experience measurable improvement in their spasticity and motor function following selective dorsal rhizotomy (SDR). The role of this operation in the treatment of other spasticity causes is less well defined. A literature review was undertaken to survey outcomes from SDRs performed outside the CP population. Multiple sclerosis was the most common diagnosis found, accounting for 74 of 145 patients described. Selective dorsal rhizotomies have also been reported in patients with traumatic brain and spinal cord injuries, ischemic and hemorrhagic stroke, neurodegenerative disease, hypoxic encephalopathy, and other causes of spasticity. Outcomes from surgery are generally described as favorable, although postoperative assessments and follow-up times are not standardized across reports. Long-term outcomes are sparsely reported. Larger numbers of patients and more detailed outcomes data have the potential to form a basis for expanding the inclusion criteria for SDR.

Evolution of gait in adolescents and young adults with spastic diplegia after selective dorsal rhizotomy in childhood: A 10 year follow-up study

2018 ◽  
Vol 64 ◽  
pp. 108-113 ◽  
Author(s):  
Marianna Romei ◽  
Laura M. Oudenhoven ◽  
Petra E.M. van Schie ◽  
Willem J.R. van Ouwerkerk ◽  
Marjolein M. van der Krogt ◽  
...  
Keyword(s):  
Young Adults ◽  
Adolescents And Young Adults ◽  
Spastic Diplegia ◽  
Selective Dorsal Rhizotomy ◽  
Dorsal Rhizotomy ◽  
Follow Up Study

Collaborative Home-Visit Program for Young Children With Motor Delays in Rural Taiwan: A Pilot Randomized Controlled Trial

2020 ◽  
Vol 100 (6) ◽  
pp. 979-994
Author(s):  
Yu-Hsin Hsieh ◽  
Hua-Fang Liao ◽  
Suh-Fang Jeng ◽  
Mei-Hui Tseng ◽  
Veronica Schiariti ◽  
...  
Keyword(s):  
Rural Areas ◽  
Home Visits ◽  
International Classification ◽  
International Classification Of Functioning ◽  
Control Group ◽  
Disability And Health ◽  
Family Centered ◽  
Experimental Group

Abstract Background Caregiver engagement and collaborative team early childhood intervention (ECI) services are international trends; however, relevant evidence of collaborative home-visiting ECI in rural areas is as yet undetermined. Objective The study aimed to investigate the effectiveness of a collaborative ECI program in a rural area of Taiwan. Design The study was a pilot randomized control led trial. Methods Children aged 6 to 33 months experiencing motor delays and their caregivers were enrolled in Taitung, Taiwan. Using stratified randomization, 24 participants were allocated to either experimental or control groups, and both received 5 home visits within 3 months. The experimental group received ECI services based on the International Classification of Functioning, Disability and Health framework and family-centered approaches. The control group received regular home visits by local social workers. Child outcomes included Pediatric Evaluation of Disability Inventory Chinese Version and Peabody Developmental Motor Scale, 2nd edition. Family outcomes included the Disability-Adapted Infant–Toddler version of Home Observation for Measurement, and Chinese versions of the Knowledge of Infant Development Inventory and Parental Stress Index-Short Form. A tester blinded to the study conducted assessments at baseline, postintervention, and 3-month follow-up. Two-way mixed analysis of variance was used with α = .05 (2-tailed). Results The experimental group improved scores on the Disability-Adapted Infant–Toddler version of Home Observation for Measurement significantly more than the control group with an effect size of 0.64 at follow-up. In other outcomes, both groups showed no significant differences. The follow-up rate was 69%, and adherence to the ECI program was acceptable. Limitations A limitation of the study was the heterogeneity of the sample. Conclusions This pilot study revealed possible effectiveness in implementing collaborative ECI programs based on family-centered approaches and the International Classification of Functioning, Disability and Health in rural areas. Larger field studies are needed to confirm our findings.

Assessment priorities in cerebral palsy using ICF core set by Iranian occupational therapists

2019 ◽  
Vol 86 (4) ◽  
pp. 289-298
Author(s):  
Parvin Raji ◽  
Afsoon Hassani Mehraban ◽  
Maryam Ahmadi ◽  
Veronica Schiariti
Keyword(s):  
Cerebral Palsy ◽  
Occupational Therapists ◽  
International Classification Of Functioning ◽  
Disability And Health ◽  
Mean Values ◽  
Icf Core Set ◽  
Core Set ◽  
Children With Cerebral Palsy ◽  
Levels Of Functioning

Background. International Classification of Functioning, Disability and Health (ICF) core set for cerebral palsy allows for the description of the levels of functioning in cerebral palsy. It is not exactly clear which of these levels is more important for evaluation from the perspective of occupational therapists in Iran. By identifying these priorities, we can establish a better plan for intervention. Purpose. This study defines assessment priorities in children with cerebral palsy (<6 years). Method. Sixty-two Iranian occupational therapists studied the priorities of assessment based on the Iranian ICF core set. The therapists were asked to rate the code categories from 1 to 3. The results are presented as mean values. Findings. Occupational therapists first focus on body functions assessment, then activities/participation, and ultimately, environmental factors. Implications. Occupational therapists in Iran have a bottom-up approach toward clients with cerebral palsy. It may be necessary to revise the educational curriculum, prepare a training course, and provide more supervision for practising occupational therapists.

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