Selective dorsal rhizotomy in Hong Kong: multidimensional outcome measures.
We prospectively case series study evaluated the short-term effectiveness of selective dorsal rhizotomy plus physiotherapy. Twenty children with spastic cerebral palsy, selected for selective dorsal rhizotomy (mean age, 8.57 years; range, 5.96-11.18 years), were assessed before, and 6 and 12 months after, selective dorsal rhizotomy. Main outcome measures included the Modified Ashworth Scale, passive range of joint movement, the Gross Motor Function Measure, the Pediatric Evaluation of Disability Inventory, the Canadian Occupational Performance Measure, and three-dimensional gait analysis. The results confirmed that selective dorsal rhizotomy plus physiotherapy provided a statistically significant reduction of spasticity, functional improvements in mobility and self-care performance, and increased participation in social situations in our study group (85% exhibited normal intelligence, and 90% belonged to Gross Motor Function Classification System levels I-III). The Gross Motor Function Measure proved to be sensitive in documenting motor functional changes, except for children at Gross Motor Function Classification System level I. Instrumental three-dimensional gait analysis with kinematics and kinetics data analysis confirmed gait improvements in children of higher motor function. The Canadian Occupational Performance Measure indicated improvements in social participation.
Child Assessment Service, Department of Health, Central Kowloon Child Assessment Centre, Kowloon, Hong Kong. sophe@netvigator.com
Sophelia Hoi-Shan
SH
Chan
Kwong Yiu
KY
Yam
Beverley Pui-Heung
BP
Yiu-Lau
Candice Yuen-Ching
CY
Poon
Nerita Nar-Chi
NN
Chan
Ho Man
HM
Cheung
Morris
M
Wu
Wai Kwong
WK
Chak
D000203:Activities of Daily Living; D001696:Biomechanical Phenomena; D002547:Cerebral Palsy / Q000523:psychology / Q000601:surgery / Q000628:therapy*; D002648:Child; D003131:Combined Modality Therapy; D005260:Female; D005684:Gait; D006723:Hong Kong; D006801:Humans; D007361:Intelligence Tests; D008297:Male; D009043:Motor Activity; D053580:Muscle Strength / Q000502:physiology; D026741:Physical Therapy Modalities; D004856:Postural Balance / Q000502:physiology; D011187:Posture / Q000502:physiology; D011446:Prospective Studies; D019051:Rhizotomy; D013126:Spinal Nerve Roots / Q000601:surgery*; D016896:Treatment Outcome; D016138:Walking / Q000502:physiology