title: Developmental skills of children with spastic diplegia: functional and qualitative changes after selective dorsal rhizotomy.
abstract: OBJECTIVE
  This study examined changes in muscle tone, passive range of motion, stability, and mobility in developmental skills at 6 months and 1 year after selective dorsal rhizotomy (SDR).
  
  
  METHODS
  Prospective outcome study of a consecutive sample.
  
  
  METHODS
  Private children's hospital.
  
  
  METHODS
  Twenty-six children with spastic diplegia: 13 independent and 13 dependent ambulators (assistive devices).
  
  
  RESULTS
  A decrease in spasticity was seen at 6 months after SDR, with no further decrease at 1 year. Increases in passive range of motion of the hip and ankle were seen at 6 months after SDR. The ability to assume and maintain developmental positions with improved alignment and stability was seen more frequently at 6 months after SDR, whereas an improvement in the ability to perform transitional movements was seen more frequently at 1 year after SDR.
  
  
  CONCLUSIONS
  SDR decreases spasticity and increases lower extremity range of motion in children with spastic diplegia and appears to be associated with the ability to assume a greater variety of developmental positions with improved alignment, thus greater stability. Improvements in the ability to perform difficult transitional movements at 1 year after SDR are most likely the result of the combined effect of maturation, SDR, and intensive therapeutic intervention.
authors.affiliation: Shriners Hospital for Children, Oregon Health Sciences University, Portland, USA.
authors.forename: C E
authors.initials: CE
authors.lastname: Buckon
authors.forename: S
authors.initials: S
authors.lastname: Thomas
authors.forename: R
authors.initials: R
authors.lastname: Pierce
authors.forename: J H
authors.initials: JH
authors.lastname: Piatt
authors.forename: M D
authors.initials: MD
authors.lastname: Aiona
mesh_terms: D000203:Activities of Daily Living; D002547:Cerebral Palsy / Q000503:physiopathology* / Q000601:surgery*; D002648:Child; D002657:Child Development; D002675:Child, Preschool; D005260:Female; D005684:Gait; D006801:Humans; D008297:Male; D009048:Motor Skills; D009989:Orthotic Devices; D011187:Posture; D011446:Prospective Studies; D016059:Range of Motion, Articular; D019051:Rhizotomy / Q000592:standards*; D013126:Spinal Nerve Roots / Q000601:surgery*; D016896:Treatment Outcome