title: Changes in the hip migration percentage and motor function in patients with cerebral palsy treated surgically by multilevel soft tissue release--preliminary report.
abstract: BACKGROUND
  Disturbed muscle balance secondary to upper motor neuron damage in the course of infantile cerebral palsy (ICP) leads to the development of progressive morphological changes in joints, especially the hip. We analysed changes in Reimers' index (hip migration percentage - MP), and functional ability in CP children after multilevel soft tissue release.
  
  
  METHODS
  We studied 22 patients with cerebral palsy following one-stage multilevel soft tissue release. The children were examined twice: one day before the surgery and at least 6 months (a mean of 9 months) after the procedure. Hip stability was evaluated radiographically using Reimers' index. Post-operative functional changes were analysed with the Gross Motor Function Measure-88 scale (GMFM-88).
  
  
  RESULTS
  Reimers' index decreased post-operatively in 20 right and 18 left hips and increased in 2 right and 4 left hips. Functional ability according to the GMFM scale increased in 17 children (by a mean of 7.1%), did not change in 3 patients with near-maximum pre-operative scores, and worsened in 2 patients.
  
  
  CONCLUSIONS
  Our study showed that, when performed for appropriate indications, multilevel soft tissue release surgery can improve hip stability and functional ability in CP children.
authors: Institute of Physiotherapy, University of Rzeszów, Poland. mszczep@univ.rzeszow.pl
authors: Magdalena
authors: M
authors: Szczepanik
authors: Joanna
authors: J
authors: Dudek
authors: Sławomir
authors: S
authors: Snela
authors: Rafał
authors: R
authors: Piasek