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Comparative effects of multilevel muscle tendon surgery, osteotomies, and dorsal rhizotomy on functional and gait outcome measures for children with cerebral palsy.

Publication ,  Journal Article
Feger, MA; Lunsford, CD; Sauer, LD; Novicoff, W; Abel, MF
Published in: PM R
May 2015

OBJECTIVE: To compare the impact of common surgical interventions (selective dorsal rhizotomy, muscle-tendon surgery, and osteotomies) for patients with cerebral palsy (CP) on Gross Motor Function Measure and temporal, kinematic, and kinetic gait variables as assessed via 3-dimensional motion analysis. DESIGN: Retrospective cohort study. SETTING: Motion analyses laboratory. PARTICIPANTS: Ninety-four patients with CP, 56 of whom underwent surgery (37, muscle-tendon surgery; 11, osteotomy; and 8, selective dorsal rhizotomy) and 38 of whom did not have surgery; the patients were ages 4-18 years, with a Gross Motor Function Classification System classification of I, II, or III. INTERVENTIONS: Single-event, multilevel muscle tendon surgery, selective dorsal rhizotomy, and osteotomy. MAIN OUTCOME MEASURES: Change scores (postintervention - preintervention) in Gross Motor Function Measure and temporal, kinematic, and kinetic gait variables. RESULTS: No statistically significant differences in change scores were found between groups in the Gross Motor Function Measure, velocity, or stride length measures after the observation period. The selective dorsal rhizotomy group had greater improvements in knee extension when compared with the nonsurgical group and greater hip and knee total range of motion during the gait cycle when compared with nonsurgical group and the muscle-tendon surgery and osteotomy cohorts. Lastly, the muscle-tendon surgery group had greater improvements in total knee range of motion compared with the nonsurgical group. CONCLUSIONS: Patients who undergo selective dorsal rhizotomy and, to a lesser extent, muscle tendon procedures demonstrate greater improvements in kinematic gait variables compared with nonsurgical interventions in patients with spasticity resulting from CP.

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Published In

PM R

DOI

EISSN

1934-1563

Publication Date

May 2015

Volume

7

Issue

5

Start / End Page

485 / 493

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Tendons
  • Rhizotomy
  • Retrospective Studies
  • Range of Motion, Articular
  • Osteotomy
  • Motor Activity
  • Male
  • Humans
  • Gait
 

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Feger, M. A., Lunsford, C. D., Sauer, L. D., Novicoff, W., & Abel, M. F. (2015). Comparative effects of multilevel muscle tendon surgery, osteotomies, and dorsal rhizotomy on functional and gait outcome measures for children with cerebral palsy. PM R, 7(5), 485–493. https://doi.org/10.1016/j.pmrj.2014.11.002
Feger, Mark A., Christopher D. Lunsford, Lindsay D. Sauer, Wendy Novicoff, and Mark F. Abel. “Comparative effects of multilevel muscle tendon surgery, osteotomies, and dorsal rhizotomy on functional and gait outcome measures for children with cerebral palsy.PM R 7, no. 5 (May 2015): 485–93. https://doi.org/10.1016/j.pmrj.2014.11.002.
Feger, Mark A., et al. “Comparative effects of multilevel muscle tendon surgery, osteotomies, and dorsal rhizotomy on functional and gait outcome measures for children with cerebral palsy.PM R, vol. 7, no. 5, May 2015, pp. 485–93. Pubmed, doi:10.1016/j.pmrj.2014.11.002.
Journal cover image

Published In

PM R

DOI

EISSN

1934-1563

Publication Date

May 2015

Volume

7

Issue

5

Start / End Page

485 / 493

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Tendons
  • Rhizotomy
  • Retrospective Studies
  • Range of Motion, Articular
  • Osteotomy
  • Motor Activity
  • Male
  • Humans
  • Gait