The Effects of Selective Dorsal Rhizotomy on Balance and Symmetry of Gait in Children with Cerebral Palsy
Cerebral palsy (CP) is associated with dysfunction of the upper motor neuron and results in balance problems and asymmetry during locomotion. Selective dorsal rhizotomy (SDR) is a surgical procedure that results in reduced afferent neuromotor signals from the lower extremities with the aim of improv...
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| description | Cerebral palsy (CP) is associated with dysfunction of the upper motor neuron and results in balance problems and asymmetry during locomotion. Selective dorsal rhizotomy (SDR) is a surgical procedure that results in reduced afferent neuromotor signals from the lower extremities with the aim of improving gait. Its influence on balance and symmetry has not been assessed. The aim of this prospective cohort study was to evaluate the impact of SDR on balance and symmetry during walking.
18 children (10 girls, 8 boys; age 6 years (y) 3 months (m), SD 1y 8m) with bilateral spastic CP and Gross Motor Function Classification System levels I to II underwent gait analysis before and 6 to 12 months after SDR. Results were compared to 11 typically developing children (TDC; 6 girls, 5 boys; age 6y 6m, SD 1y 11m). To analyse balance, sway velocity, radial displacement and frequency were calculated. Symmetry ratios were calculated for balance measures and spatio-temporal parameters during walking.
Most spatio-temporal parameters of gait, as well as all parameters of balance, improved significantly after SDR. Preoperative values of symmetry did not vary considerably between CP and TDC group and significant postoperative improvement did not occur.
The reduction of afferent signalling through SDR improves gait by reducing balance problems rather than enhancing movement symmetry. |
| doi_str_mv | 10.1371/journal.pone.0152930 |
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18 children (10 girls, 8 boys; age 6 years (y) 3 months (m), SD 1y 8m) with bilateral spastic CP and Gross Motor Function Classification System levels I to II underwent gait analysis before and 6 to 12 months after SDR. Results were compared to 11 typically developing children (TDC; 6 girls, 5 boys; age 6y 6m, SD 1y 11m). To analyse balance, sway velocity, radial displacement and frequency were calculated. Symmetry ratios were calculated for balance measures and spatio-temporal parameters during walking.
Most spatio-temporal parameters of gait, as well as all parameters of balance, improved significantly after SDR. Preoperative values of symmetry did not vary considerably between CP and TDC group and significant postoperative improvement did not occur.
The reduction of afferent signalling through SDR improves gait by reducing balance problems rather than enhancing movement symmetry.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0152930</identifier><identifier>PMID: 27043310</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Analysis ; Asymmetry ; Balance ; Biology and Life Sciences ; Care and treatment ; Cerebral palsy ; Cerebral Palsy - diagnosis ; Cerebral Palsy - physiopathology ; Cerebral Palsy - surgery ; Child ; Child, Preschool ; Children ; Children & youth ; Complications and side effects ; Electromyography ; Extremities ; Female ; Gait ; Girls ; Humans ; Kinematics ; Locomotion ; Male ; Mathematical analysis ; Medicine and Health Sciences ; Neurosurgery ; Paralysis ; Patient outcomes ; People and Places ; Physiological aspects ; Postural Balance ; Posture ; Rhizotomy ; Sensory neurons ; Signaling ; Spinal Nerve Roots - surgery ; Surgery ; Symmetry ; Treatment Outcome ; Walking ; Young adults</subject><ispartof>PloS one, 2016-04, Vol.11 (4), p.e0152930-e0152930</ispartof><rights>COPYRIGHT 2016 Public Library of Science</rights><rights>2016 Rumberg et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2016 Rumberg et al 2016 Rumberg et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c692t-49cabc63979ce9d6c272020fb2a07b9ec438b8803de99010c9eac6a6c8771cf23</citedby><cites>FETCH-LOGICAL-c692t-49cabc63979ce9d6c272020fb2a07b9ec438b8803de99010c9eac6a6c8771cf23</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4820221/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4820221/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,315,728,781,785,865,886,2103,2929,23868,27926,27927,53793,53795</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27043310$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Martinuzzi, Andrea</contributor><creatorcontrib>Rumberg, Franziska</creatorcontrib><creatorcontrib>Bakir, Mustafa Sinan</creatorcontrib><creatorcontrib>Taylor, William R</creatorcontrib><creatorcontrib>Haberl, Hannes</creatorcontrib><creatorcontrib>Sarpong, Akosua</creatorcontrib><creatorcontrib>Sharankou, Ilya</creatorcontrib><creatorcontrib>Lebek, Susanne</creatorcontrib><creatorcontrib>Funk, Julia F</creatorcontrib><title>The Effects of Selective Dorsal Rhizotomy on Balance and Symmetry of Gait in Children with Cerebral Palsy</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>Cerebral palsy (CP) is associated with dysfunction of the upper motor neuron and results in balance problems and asymmetry during locomotion. Selective dorsal rhizotomy (SDR) is a surgical procedure that results in reduced afferent neuromotor signals from the lower extremities with the aim of improving gait. Its influence on balance and symmetry has not been assessed. The aim of this prospective cohort study was to evaluate the impact of SDR on balance and symmetry during walking.
18 children (10 girls, 8 boys; age 6 years (y) 3 months (m), SD 1y 8m) with bilateral spastic CP and Gross Motor Function Classification System levels I to II underwent gait analysis before and 6 to 12 months after SDR. Results were compared to 11 typically developing children (TDC; 6 girls, 5 boys; age 6y 6m, SD 1y 11m). To analyse balance, sway velocity, radial displacement and frequency were calculated. Symmetry ratios were calculated for balance measures and spatio-temporal parameters during walking.
Most spatio-temporal parameters of gait, as well as all parameters of balance, improved significantly after SDR. Preoperative values of symmetry did not vary considerably between CP and TDC group and significant postoperative improvement did not occur.
The reduction of afferent signalling through SDR improves gait by reducing balance problems rather than enhancing movement symmetry.</description><subject>Analysis</subject><subject>Asymmetry</subject><subject>Balance</subject><subject>Biology and Life Sciences</subject><subject>Care and treatment</subject><subject>Cerebral palsy</subject><subject>Cerebral Palsy - diagnosis</subject><subject>Cerebral Palsy - physiopathology</subject><subject>Cerebral Palsy - surgery</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Children</subject><subject>Children & youth</subject><subject>Complications and side effects</subject><subject>Electromyography</subject><subject>Extremities</subject><subject>Female</subject><subject>Gait</subject><subject>Girls</subject><subject>Humans</subject><subject>Kinematics</subject><subject>Locomotion</subject><subject>Male</subject><subject>Mathematical analysis</subject><subject>Medicine and Health Sciences</subject><subject>Neurosurgery</subject><subject>Paralysis</subject><subject>Patient outcomes</subject><subject>People and Places</subject><subject>Physiological aspects</subject><subject>Postural Balance</subject><subject>Posture</subject><subject>Rhizotomy</subject><subject>Sensory neurons</subject><subject>Signaling</subject><subject>Spinal Nerve Roots - 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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Rumberg, Franziska</au><au>Bakir, Mustafa Sinan</au><au>Taylor, William R</au><au>Haberl, Hannes</au><au>Sarpong, Akosua</au><au>Sharankou, Ilya</au><au>Lebek, Susanne</au><au>Funk, Julia F</au><au>Martinuzzi, Andrea</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The Effects of Selective Dorsal Rhizotomy on Balance and Symmetry of Gait in Children with Cerebral Palsy</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2016-04-04</date><risdate>2016</risdate><volume>11</volume><issue>4</issue><spage>e0152930</spage><epage>e0152930</epage><pages>e0152930-e0152930</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Cerebral palsy (CP) is associated with dysfunction of the upper motor neuron and results in balance problems and asymmetry during locomotion. Selective dorsal rhizotomy (SDR) is a surgical procedure that results in reduced afferent neuromotor signals from the lower extremities with the aim of improving gait. Its influence on balance and symmetry has not been assessed. The aim of this prospective cohort study was to evaluate the impact of SDR on balance and symmetry during walking.
18 children (10 girls, 8 boys; age 6 years (y) 3 months (m), SD 1y 8m) with bilateral spastic CP and Gross Motor Function Classification System levels I to II underwent gait analysis before and 6 to 12 months after SDR. Results were compared to 11 typically developing children (TDC; 6 girls, 5 boys; age 6y 6m, SD 1y 11m). To analyse balance, sway velocity, radial displacement and frequency were calculated. Symmetry ratios were calculated for balance measures and spatio-temporal parameters during walking.
Most spatio-temporal parameters of gait, as well as all parameters of balance, improved significantly after SDR. Preoperative values of symmetry did not vary considerably between CP and TDC group and significant postoperative improvement did not occur.
The reduction of afferent signalling through SDR improves gait by reducing balance problems rather than enhancing movement symmetry.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>27043310</pmid><doi>10.1371/journal.pone.0152930</doi><oa>free_for_read</oa></addata></record> |
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| subjects | Analysis Asymmetry Balance Biology and Life Sciences Care and treatment Cerebral palsy Cerebral Palsy - diagnosis Cerebral Palsy - physiopathology Cerebral Palsy - surgery Child Child, Preschool Children Children & youth Complications and side effects Electromyography Extremities Female Gait Girls Humans Kinematics Locomotion Male Mathematical analysis Medicine and Health Sciences Neurosurgery Paralysis Patient outcomes People and Places Physiological aspects Postural Balance Posture Rhizotomy Sensory neurons Signaling Spinal Nerve Roots - surgery Surgery Symmetry Treatment Outcome Walking Young adults |
| title | The Effects of Selective Dorsal Rhizotomy on Balance and Symmetry of Gait in Children with Cerebral Palsy |
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