Selective dorsal rhizotomy in cerebral palsy to improve functional abilities: evaluation of criteria for selection.
OBJECTIVE
The aim of this study is to evaluate the effect of selective dorsal rhizotomy (SDR) on functional abilities in a well-defined group of ambulatory children with spastic diplegia.


METHODS
Nine children were selected for SDR (mean age 65 months, range 43-82 months). Gross motor function was measured with the Gross Motor Function Measure (GMFM-88). Self-care was assessed with the Pediatric Evaluation of Disability Inventory (PEDI) and gait pattern was measured with the Edinburgh Visual Gait Score (EGS). There were nine single-case research designs with a 12-month follow-up after surgery.


RESULTS
After 12 months the mean improvement in the total GMFM-88 scores was 8.8%. On an individual level, all patients improved significantly in comparison with baseline. Functional skills and care-giver assistance measured with the PEDI showed significant improvement. Improvement in gait was also found; in particular, better initial contact and heel-lift resulted in an increased EGS.


CONCLUSIONS
In this well-defined group of ambulatory children SDR had a small but significant positive effect on gross motor function, self-care and gait pattern.
van Schie
Petra E M
PE
Department of Rehabilitation Medicine, VU University Medical Center, De Boelelaan 1117, P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands. pem.vanschie@vumc.nl
Vermeulen
R Jeroen
RJ
van Ouwerkerk
Willem J R
WJ
Kwakkel
Gert
G
Becher
Jules G
JG
D000203:Activities of Daily Living; D002547:Cerebral Palsy / Q000503:physiopathology / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D004185:Disability Evaluation; D005069:Evaluation Studies as Topic; D005260:Female; D005500:Follow-Up Studies; D007839:Functional Laterality; D005684:Gait / Q000502:physiology; D006801:Humans; D008297:Male; D009043:Motor Activity / Q000502:physiology*; D009460:Neurologic Examination; D010043:Outcome and Process Assessment, Health Care; D026741:Physical Therapy Modalities; D011446:Prospective Studies; D020127:Recovery of Function; D019051:Rhizotomy / Q000379:methods*; D012648:Self Care; D013126:Spinal Nerve Roots / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome