Functional outcomes following selective posterior rhizotomy in children with cerebral palsy

1991 ◽  
Vol 74 (3) ◽  
pp. 380-385 ◽  
Author(s):  
Warwick J. Peacock ◽  
Loretta A. Staudt
Keyword(s):  
Cerebral Palsy ◽  
Range Of Motion ◽  
Muscle Tone ◽  
Functional Mobility ◽  
Spastic Cerebral Palsy ◽  
Range Of Movement ◽  
Content Type ◽  
Before And After ◽  
The Status ◽  
Selective Posterior Rhizotomy

✓ The recent increase in popularity of selective posterior rhizotomy demands objective documentation of surgical outcome. For this reason, the authors have analyzed the status of 25 children with spastic cerebral palsy before and after rhizotomy to determine the effects of this therapy on muscle tone, range of movement, and motor function. Postoperative tests showed a reduction in muscle tone compared with preoperative assessments. Range of motion in the lower extremities was significantly increased and improvements in functional gross motor skills were noted. An increase in range of motion in the knees and thighs during gait was detected in 18 ambulatory patients studied with computerized two-dimensional motion analysis. Preliminary findings indicate that selective posterior rhizotomy reduced spasticity, thereby increasing range of motion and contributing to improvements in active functional mobility.

scholarly journals The effects of kinesio taping of lower limbs on functional mobility, spasticity, and range of motion of children with spastic cerebral palsy

2019 ◽  
Vol 55 (1) ◽  
Author(s):  
Mirjavad Tabatabaee ◽  
Moslem Cheraghifard ◽  
Alireza Shamsoddini
Keyword(s):  
Cerebral Palsy ◽  
Range Of Motion ◽  
Muscle Tone ◽  
Intervention Group ◽  
Treatment Method ◽  
Functional Mobility ◽  
Lower Limbs ◽  
Spastic Cerebral Palsy ◽  
Control Group ◽  
Kinesio Taping

Abstract Background Cerebral palsy (CP) is a non-progressive neurological disease in a growing brain. Objective The aim of this study was to explore the effects of kinesio taping (KT) of the lower limbs on functional mobility, spasticity, and range of motion (ROM) of children with cerebral palsy. Methods Thirty children with spastic cerebral palsy aged 3 to 10 years old were selected from pediatric rehabilitation clinics. Subjects were divided randomly into intervention and control groups. Each group contains 15 subjects. Both groups received kinesio taping along with occupational therapy for 2 weeks. In the intervention group, kinesio taping was applied in a treatment mode with suitable tension; however, taping was applied in the control group in a sham mode. Timed get up and go (TUG), Modified Modified Ashworth (MMA), and goniometer tests were used prior to the intervention and 2 days and 2 weeks after the intervention. Results Short-term application of kinesio taping in the intervention group did not lead to significant changes in ROM (P = 0.582), muscle tone (P = 0.317), and functional mobility (P = 0.320). However, long-term application of kinesio taping improved the range of motion, muscle tone, and functional mobility (P < 0.05). No significant change has been observed in the control group in different intervals. Conclusion The findings indicated that kinesio taping can increase ROM of the knee and reduce spasticity. It also can improve the functional mobility. Therefore, it seems that kinesio taping is efficient for rehabilitation of spastic CP as a reliable treatment method. Trial registration IRCT, IRCT2017082135822N1, Registered 19 September 2017, https://fa.irct.ir/IRCT2017082135822N1.

Cerebral palsy and rhizotomy: A 3-year follow-up evaluation with gait analysis

1991 ◽  
Vol 74 (2) ◽  
pp. 178-184 ◽  
Author(s):  
Christopher L. Vaughan ◽  
Barbara Berman ◽  
Warwick J. Peacock
Keyword(s):  
Cerebral Palsy ◽  
Gait Analysis ◽  
Range Of Motion ◽  
Stride Length ◽  
Sagittal Plane ◽  
Spastic Cerebral Palsy ◽  
Normal Range ◽  
Early Functional Outcome ◽  
Selective Posterior Rhizotomy

✓ A recent increase in the popularity of selective posterior rhizotomy for reduction of spasticity in cerebral palsy has led to a demand for more objective studies of outcome and long-term follow-up results. The authors present the results of gait analysis on 14 children with spastic cerebral palsy, who underwent selective posterior rhizotomy in 1985. Sagittal plane gait patterns were studied before surgery and at 1 and 3 years after surgery using a digital camera system. The parameters measured included the range of motion at the knee and thigh, stride length, speed of walking, and cadence. The range of motion at the knee was significantly increased at 1 year after surgery and further improved to a nearly normal range at 3 years after surgery. In contrast, postoperative measurements of thigh range exceeded normal values at 1 year, but decreased toward normal range at 3 years. While improvements in range of motion continued between Years 1 and 3, the children developed a more extended thigh and knee position, which indicated a more upright walking posture. Stride length and speed of walking also improved, while cadence remained essentially unchanged. This 3-year follow-up study, the first to examine rhizotomy using an objective approach, has provided some encouraging results regarding early functional outcome.

Why is joint range of motion limited in patients with cerebral palsy?

2012 ◽  
Vol 38 (1) ◽  
pp. 8-13 ◽  
Author(s):  
M. de Bruin ◽  
M. J. C. Smeulders ◽  
M. Kreulen
Keyword(s):  
Cerebral Palsy ◽  
Range Of Motion ◽  
Muscle Tone ◽  
Surrounding Tissue ◽  
Spastic Cerebral Palsy ◽  
Joint Angles ◽  
Joint Range Of Motion ◽  
Joint Range ◽  
Selection Of Patients ◽  
Selection Of

Patients with spastic cerebral palsy of the upper limb typically present with various problems including an impaired range of motion that affects the positioning of the upper extremity. This impaired range of motion often develops into contractures that further limit functioning of the spastic hand and arm. Understanding why these contractures develop in cerebral palsy will affect the selection of patients suitable for surgical treatment as well as the choice for specific surgical procedures. The generally accepted hypothesis in patients with spastic cerebral palsy is that the hyper-excitability of the stretch reflex combined with increased muscle tone result in extreme angles of the involved joints at rest. Ultimately, these extreme joint angles are thought to result in fixed joint postures. There is no consensus in the literature concerning the pathophysiology of this process. Several hypotheses associated with inactivity and overactivity have been tested by examining the secondary changes in spastic muscle and its surrounding tissue. All hypotheses implicate different secondary changes that consequently require different clinical approaches. In this review, the different hypotheses concerning the development of limited joint range of motion in cerebral palsy are discussed in relation to their secondary changes on the musculoskeletal system.

Examination of intersegmental coordination in spastic cerebral palsy patients before and after selective posterior rhizotomy

1994 ◽  
Vol 2 (1) ◽  
pp. 61
Author(s):  
Jonathan Drezner ◽  
Loretta Staudt ◽  
Eileen Fowler ◽  
Alan Garfinkel ◽  
Warwick Peacock
Keyword(s):  
Cerebral Palsy ◽  
Spastic Cerebral Palsy ◽  
Intersegmental Coordination ◽  
Before And After ◽  
Selective Posterior Rhizotomy

scholarly journals Effects of ziclague phytotherapic associated with kinesitherapy on the equine foot of children with spastic cerebral palsy

2020 ◽  
Vol 18 ◽  
pp. 1-8
Author(s):  
Jéssika Da Silva Martins ◽  
Marina Ortega Golin
Keyword(s):  
Cerebral Palsy ◽  
Range Of Motion ◽  
Lower Limb ◽  
Spastic Cerebral Palsy ◽  
Active Movement ◽  
Triceps Muscle ◽  
Modified Ashworth Scale ◽  
Before And After ◽  
The Right ◽  
Ashworth Scale

Background: Spasticity is the most common disorder of Cerebral Palsy (CP) and has the characteristics of decreased active movement,elastic hypertonia and hyperreflexia. Because of this, one of the main purposes of treatment is to decrease hypertonia. Thus, the herbalmedicine Ziclague®, having an antispasmodic action, may offer a new possibility in addition to physiotherapy. Objective: Verify theeffects of the application of the herbal medicine Ziclague on hypertonia of the sural triceps muscle of children with spasticCP. Methods: Ten children, between one and seven years of age, received application of Ziclague® spray on the triceps sural musclebefore the physiotherapy sessions, during the period of twelve weeks. Evaluations were performed using the Modified Ashworth Scale(MAS), Durigon Protocol (DP) and goniometry, before and after application on the first day, after four weeks and at the end of twelveweeks. The four evaluations were compared. Results: After twelve weeks the results were more evident, with a decrease in hypertoniaof the right lower limb (RLL) and left lower limb (LLL) verified by MAS (p= 0.06 and p= 0.13), and by the DP (p= 0.003 and p= 0.007).Goniometry showed increased range of motion for dorsiflexion of the RLL (p= 0.002) and LLL (p= 0.111). Conclusion: The use ofZiclague® associated with physiotherapy had a positive effect in decreasing hypertonia of the sural triceps muscle and in increasing theankle dorsiflexion range of motion.

EFEITOS DO DEEP RUNNING SOBRE A AMPLITUDE DE MOVIMENTO E A CAPACIDADE FUNCIONAL DOS MEMBROS SUPERIORES DE MULHERES MASTECTOMIZADAS: RELATO DE CASOS

2019 ◽  
pp. 121-131
Keyword(s):  
Range Of Motion ◽  
Upper Limb ◽  
Functional Capacity ◽  
External Rotation ◽  
Treatment Protocol ◽  
Range Of Movement ◽  
Flexion Extension ◽  
Before And After ◽  
In The Beginning ◽  
And Function

Introduction: Breast cancer is the most common type of cancer among women in Brazil and in the worl. The surgical treatment procedure may cause severe morbidity in the upper limb homolateral to surgery, including the reduction of the range of motion, with consequent impairment of function. A physiotherapeutic approach has an important role in the recover range of motion and the functionality of these women, guaranteeing the occupational, domestestic, familiar and conjugated activities, and, in this way, also improving the quality of life. Objectives: To analyse chances in the shoulder's range of motion and the functional capacity of the upper limbs, promoted by the deep running procedure in women with late postoperative mastectomy. Methods: All the patients were submitted to an evaluation in the beginning and end of the treatment, including: goniometry of flexion, extension, abduction, adduction, internal and external rotation of the shoulder joint; and function capacity analysis in activities that involve the upper members by DASH questionnaire. The treatment protocol includes twelve sessions of deep running, realized twice a week, in deep pool, for 20-minute during six weeks. Results: Were submitted to treatment a total of 4 patients. Despite the improvement in the numerical values, statistically significant differences were not found on the range of movements and in the functional capacity of upper members before and after the deep running sessions in post-mastectomy women. Conclusion: Deep running had effects on the numerical values of range of movement and upper limb functionality in women in the late postoperative period of the mastectomy procedure, but without statistically significant differences.

Infusion of intrathecal baclofen for generalized dystonia in cerebral palsy

1998 ◽  
Vol 88 (1) ◽  
pp. 73-76 ◽  
Author(s):  
A. Leland Albright ◽  
Margaret J. Barry ◽  
Michael J. Painter ◽  
Barbara Shultz
Keyword(s):  
Cerebral Palsy ◽  
Intrathecal Baclofen ◽  
Term Therapy ◽  
Short Term ◽  
Intrathecal Catheter ◽  
Content Type ◽  
Body Regions ◽  
Before And After ◽  
Generalized Dystonia ◽  
Fine Print

Generalized dystonia occurs in 15 to 25% of persons with cerebral palsy (CP) and responds poorly to medical and surgical treatments. Object. After the authors observed a woman whose dystonic CP was dramatically improved by continuous infusion of intrathecal baclofen, they designed this pilot study to evaluate the effect of this treatment on a group of patients with dystonic CP. Methods. The authors assessed the short-term response to intrathecal baclofen infusion in 12 patients with dystonic CP. An intrathecal catheter was inserted percutaneously and connected to an external microinfusion pump. The infusion began at a rate of 100 µg/day and was increased by 50 µg every 12 hours until the dystonia abated, adverse effects occurred, or the dose reached 900 mg/day with no improvement. Two observers, one blinded and one not blinded to the patient's treatment status, viewed videotapes made before and after the infusions and graded the dystonia in eight body regions, using a 5-point scale. Overall and regional scores were compared by using Wilcoxon signed-rank tests. Conclusions. Dystonia diminished in 10 of 12 patients whose average daily dose of intrathecal baclofen was 575 µg. Overall dystonia scores and scores for the extremities, trunk, and cervical regions were significantly better after infusion (p = 0.003). The two observers' scores were not significantly different. Programmable infusion pumps were subsequently implanted in eight patients for long-term therapy and improvement was sustained in six (p < 0.05). Intrathecal baclofen infusion is a promising treatment option for generalized dystonia associated with CP. The effects of intrathecal baclofen infusion on dystonia can be evaluated by using short-term continuous infusions.

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