Does loss of spasticity matter? A 10‐year follow‐up after selective dorsal rhizotomy in cerebral palsy
Aim The aim of this study was to evaluate the long‐term effects of selective dorsal rhizotomy (SDR) in children with cerebral palsy (CP). Method Nineteen children (four females, 15 males; mean age 4y 7mo, SD 1y 7mo) with bilateral spastic CP, were prospectively assessed at baseline and 18 months,...
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| Veröffentlicht in: | Developmental medicine and child neurology 2011-08, Vol.53 (8), p.724-729 |
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| creator | TEDROFF, KRISTINA LÖWING, KRISTINA JACOBSON, DAN N O ÅSTRÖM, EVA |
| description | Aim The aim of this study was to evaluate the long‐term effects of selective dorsal rhizotomy (SDR) in children with cerebral palsy (CP).
Method Nineteen children (four females, 15 males; mean age 4y 7mo, SD 1y 7mo) with bilateral spastic CP, were prospectively assessed at baseline and 18 months, 3 years, and 10 years after SDR. Assessments included the Modified Ashworth Scale for spasticity, the Gross Motor Function Measure 88 (GMFM‐88) and the Wilson gait scale for ambulation, neurological investigations, and passive joint range of motion assessment. A 10‐year retrospective chart review was added for orthopaedic surgery after SDR.
Results Baseline muscle tone at the hip, knee, and ankle level displayed a high degree of spasticity that normalized after SDR. After 10 years there was a slight recurrence of spasticity at the knee and ankle. Joint range of motion declined from a maximum at 3 years after SDR to the 10‐year follow‐up. Median ambulatory status was best 3 years after SDR and then declined. The GMFM‐88 score increased from the median baseline value of 51 to 66 (p=0.002) and 76 (p |
| doi_str_mv | 10.1111/j.1469-8749.2011.03969.x |
| format | Article |
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Method Nineteen children (four females, 15 males; mean age 4y 7mo, SD 1y 7mo) with bilateral spastic CP, were prospectively assessed at baseline and 18 months, 3 years, and 10 years after SDR. Assessments included the Modified Ashworth Scale for spasticity, the Gross Motor Function Measure 88 (GMFM‐88) and the Wilson gait scale for ambulation, neurological investigations, and passive joint range of motion assessment. A 10‐year retrospective chart review was added for orthopaedic surgery after SDR.
Results Baseline muscle tone at the hip, knee, and ankle level displayed a high degree of spasticity that normalized after SDR. After 10 years there was a slight recurrence of spasticity at the knee and ankle. Joint range of motion declined from a maximum at 3 years after SDR to the 10‐year follow‐up. Median ambulatory status was best 3 years after SDR and then declined. The GMFM‐88 score increased from the median baseline value of 51 to 66 (p=0.002) and 76 (p<0.001) at the initial follow‐ups. After 10 years there was a decline in gross motor function with a reduction in the GMFM‐88 score to 62 (p=0.022). Within 10 years, 16 out of 19 patients had a mean of three orthopaedic surgeries (SD 2.8), soft tissue surgery being the most common.
Interpretation The spasticity‐reducing effect of SDR, although pronounced, did not seem to improve long‐term functioning or prevent contractures. This suggests that contracture development in CP is not mediated by spasticity alone.</description><identifier>ISSN: 0012-1622</identifier><identifier>EISSN: 1469-8749</identifier><identifier>DOI: 10.1111/j.1469-8749.2011.03969.x</identifier><identifier>PMID: 21585367</identifier><identifier>CODEN: DMCNAW</identifier><language>eng</language><publisher>Oxford, UK: Blackwell Publishing Ltd</publisher><subject>Cerebral Palsy ; Cerebral Palsy - surgery ; Child ; Child, Preschool ; Children ; Disability Evaluation ; Female ; Followup Studies ; Gait ; Humans ; Longitudinal Studies ; Male ; Muscle Spasticity - etiology ; Orthopedic Procedures - methods ; Patients ; Physical Disabilities ; Postoperative Complications - etiology ; Psychomotor Skills ; Range of Motion, Articular ; Retrospective Studies ; Rhizotomy - adverse effects ; Severity of Illness Index ; Statistics as Topic ; Statistics, Nonparametric ; Surgery ; Time Factors ; Treatment Outcome</subject><ispartof>Developmental medicine and child neurology, 2011-08, Vol.53 (8), p.724-729</ispartof><rights>2011 The Authors. Developmental Medicine & Child Neurology © 2011 Mac Keith Press</rights><rights>2011 The Authors. Developmental Medicine & Child Neurology © 2011 Mac Keith Press.</rights><rights>Copyright Blackwell Publishing Ltd. Aug 2011</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c5229-cae5843165703ad1368d0fe083ea2d3b2be8d8e58ddde5c7dfbd61fdf1801c0b3</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fj.1469-8749.2011.03969.x$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fj.1469-8749.2011.03969.x$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>230,314,776,780,881,1411,1427,27901,27902,45550,45551,46384,46808</link.rule.ids><backlink>$$Uhttp://eric.ed.gov/ERICWebPortal/detail?accno=EJ931283$$DView record in ERIC$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21585367$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttp://kipublications.ki.se/Default.aspx?queryparsed=id:122885862$$DView record from Swedish Publication Index$$Hfree_for_read</backlink></links><search><creatorcontrib>TEDROFF, KRISTINA</creatorcontrib><creatorcontrib>LÖWING, KRISTINA</creatorcontrib><creatorcontrib>JACOBSON, DAN N O</creatorcontrib><creatorcontrib>ÅSTRÖM, EVA</creatorcontrib><title>Does loss of spasticity matter? A 10‐year follow‐up after selective dorsal rhizotomy in cerebral palsy</title><title>Developmental medicine and child neurology</title><addtitle>Dev Med Child Neurol</addtitle><description>Aim The aim of this study was to evaluate the long‐term effects of selective dorsal rhizotomy (SDR) in children with cerebral palsy (CP).
Method Nineteen children (four females, 15 males; mean age 4y 7mo, SD 1y 7mo) with bilateral spastic CP, were prospectively assessed at baseline and 18 months, 3 years, and 10 years after SDR. Assessments included the Modified Ashworth Scale for spasticity, the Gross Motor Function Measure 88 (GMFM‐88) and the Wilson gait scale for ambulation, neurological investigations, and passive joint range of motion assessment. A 10‐year retrospective chart review was added for orthopaedic surgery after SDR.
Results Baseline muscle tone at the hip, knee, and ankle level displayed a high degree of spasticity that normalized after SDR. After 10 years there was a slight recurrence of spasticity at the knee and ankle. Joint range of motion declined from a maximum at 3 years after SDR to the 10‐year follow‐up. Median ambulatory status was best 3 years after SDR and then declined. The GMFM‐88 score increased from the median baseline value of 51 to 66 (p=0.002) and 76 (p<0.001) at the initial follow‐ups. After 10 years there was a decline in gross motor function with a reduction in the GMFM‐88 score to 62 (p=0.022). Within 10 years, 16 out of 19 patients had a mean of three orthopaedic surgeries (SD 2.8), soft tissue surgery being the most common.
Interpretation The spasticity‐reducing effect of SDR, although pronounced, did not seem to improve long‐term functioning or prevent contractures. This suggests that contracture development in CP is not mediated by spasticity alone.</description><subject>Cerebral Palsy</subject><subject>Cerebral Palsy - surgery</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Children</subject><subject>Disability Evaluation</subject><subject>Female</subject><subject>Followup Studies</subject><subject>Gait</subject><subject>Humans</subject><subject>Longitudinal Studies</subject><subject>Male</subject><subject>Muscle Spasticity - etiology</subject><subject>Orthopedic Procedures - methods</subject><subject>Patients</subject><subject>Physical Disabilities</subject><subject>Postoperative Complications - etiology</subject><subject>Psychomotor Skills</subject><subject>Range of Motion, Articular</subject><subject>Retrospective Studies</subject><subject>Rhizotomy - adverse effects</subject><subject>Severity of Illness Index</subject><subject>Statistics as Topic</subject><subject>Statistics, Nonparametric</subject><subject>Surgery</subject><subject>Time Factors</subject><subject>Treatment Outcome</subject><issn>0012-1622</issn><issn>1469-8749</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNpdkc1u1DAURi0EokPhDRCy2LBK8E_iOBtQNS0FVGADa8uxb4RDMg52wjSseASesU-CwwyzwJtr33PkK_tDCFOS07RedjktRJ3JqqhzRijNCa9Fnd_eQ5sTuI82hFCWUcHYGXoUY0cI4aIsHqIzRktZclFtUHfpIeLex4h9i-Oo4-SMmxY86GmC8BpfpKF3v34voANufd_7fTrNI9ZtwjhCD2ZyPwBbH6LucfjqfvrJDwt2O2wgQBNSd9R9XB6jB22q8ORYz9GXN1eft2-zm0_X77YXN5kpGaszo6GUBaeirAjXlnIhLWmBSA6aWd6wBqSVybHWQmkq2zZW0Na2VBJqSMPPUXa4N-5hnBs1BjfosCivnTq2vqUdqLIomGDJf3Hwx-C_zxAnNbhooO_1DvwclazKoiaCrObz_8zOz2GXHqOkpFVFiFylZ0dpbgawp_H__jwJTw8CBGdO-Op9zSmTPOFXB7x3PSwnTolao1edWhNWa8JqjV79jV7dqssP24_rlv8ByJCkRQ</recordid><startdate>201108</startdate><enddate>201108</enddate><creator>TEDROFF, KRISTINA</creator><creator>LÖWING, KRISTINA</creator><creator>JACOBSON, DAN N O</creator><creator>ÅSTRÖM, EVA</creator><general>Blackwell Publishing Ltd</general><general>Wiley-Blackwell</general><general>Mac Keith Press</general><scope>7SW</scope><scope>BJH</scope><scope>BNH</scope><scope>BNI</scope><scope>BNJ</scope><scope>BNO</scope><scope>ERI</scope><scope>PET</scope><scope>REK</scope><scope>WWN</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>0-V</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88B</scope><scope>88E</scope><scope>88G</scope><scope>88I</scope><scope>8AF</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ALSLI</scope><scope>AN0</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>CJNVE</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB0</scope><scope>M0P</scope><scope>M0S</scope><scope>M1P</scope><scope>M2M</scope><scope>M2P</scope><scope>NAPCQ</scope><scope>PQEDU</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PSYQQ</scope><scope>Q9U</scope><scope>S0X</scope><scope>7X8</scope><scope>ADTPV</scope><scope>AOWAS</scope></search><sort><creationdate>201108</creationdate><title>Does loss of spasticity matter? A 10‐year follow‐up after selective dorsal rhizotomy in cerebral palsy</title><author>TEDROFF, KRISTINA ; LÖWING, KRISTINA ; JACOBSON, DAN N O ; ÅSTRÖM, EVA</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c5229-cae5843165703ad1368d0fe083ea2d3b2be8d8e58ddde5c7dfbd61fdf1801c0b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Cerebral Palsy</topic><topic>Cerebral Palsy - surgery</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Children</topic><topic>Disability Evaluation</topic><topic>Female</topic><topic>Followup Studies</topic><topic>Gait</topic><topic>Humans</topic><topic>Longitudinal Studies</topic><topic>Male</topic><topic>Muscle Spasticity - etiology</topic><topic>Orthopedic Procedures - methods</topic><topic>Patients</topic><topic>Physical Disabilities</topic><topic>Postoperative Complications - etiology</topic><topic>Psychomotor Skills</topic><topic>Range of Motion, Articular</topic><topic>Retrospective Studies</topic><topic>Rhizotomy - adverse effects</topic><topic>Severity of Illness Index</topic><topic>Statistics as Topic</topic><topic>Statistics, Nonparametric</topic><topic>Surgery</topic><topic>Time Factors</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>TEDROFF, KRISTINA</creatorcontrib><creatorcontrib>LÖWING, KRISTINA</creatorcontrib><creatorcontrib>JACOBSON, DAN N O</creatorcontrib><creatorcontrib>ÅSTRÖM, EVA</creatorcontrib><collection>ERIC</collection><collection>ERIC (Ovid)</collection><collection>ERIC</collection><collection>ERIC</collection><collection>ERIC (Legacy Platform)</collection><collection>ERIC( SilverPlatter )</collection><collection>ERIC</collection><collection>ERIC PlusText (Legacy Platform)</collection><collection>Education Resources Information Center (ERIC)</collection><collection>ERIC</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>ProQuest Social Sciences Premium Collection</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Education Database (Alumni Edition)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Psychology Database (Alumni)</collection><collection>Science Database (Alumni Edition)</collection><collection>STEM Database</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>Social Science Premium Collection</collection><collection>British Nursing Database</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Education Collection</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Education Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest Psychology</collection><collection>Science Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Education</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest One Psychology</collection><collection>ProQuest Central Basic</collection><collection>SIRS Editorial</collection><collection>MEDLINE - Academic</collection><collection>SwePub</collection><collection>SwePub Articles</collection><jtitle>Developmental medicine and child neurology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>TEDROFF, KRISTINA</au><au>LÖWING, KRISTINA</au><au>JACOBSON, DAN N O</au><au>ÅSTRÖM, EVA</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><ericid>EJ931283</ericid><atitle>Does loss of spasticity matter? A 10‐year follow‐up after selective dorsal rhizotomy in cerebral palsy</atitle><jtitle>Developmental medicine and child neurology</jtitle><addtitle>Dev Med Child Neurol</addtitle><date>2011-08</date><risdate>2011</risdate><volume>53</volume><issue>8</issue><spage>724</spage><epage>729</epage><pages>724-729</pages><issn>0012-1622</issn><eissn>1469-8749</eissn><coden>DMCNAW</coden><abstract>Aim The aim of this study was to evaluate the long‐term effects of selective dorsal rhizotomy (SDR) in children with cerebral palsy (CP).
Method Nineteen children (four females, 15 males; mean age 4y 7mo, SD 1y 7mo) with bilateral spastic CP, were prospectively assessed at baseline and 18 months, 3 years, and 10 years after SDR. Assessments included the Modified Ashworth Scale for spasticity, the Gross Motor Function Measure 88 (GMFM‐88) and the Wilson gait scale for ambulation, neurological investigations, and passive joint range of motion assessment. A 10‐year retrospective chart review was added for orthopaedic surgery after SDR.
Results Baseline muscle tone at the hip, knee, and ankle level displayed a high degree of spasticity that normalized after SDR. After 10 years there was a slight recurrence of spasticity at the knee and ankle. Joint range of motion declined from a maximum at 3 years after SDR to the 10‐year follow‐up. Median ambulatory status was best 3 years after SDR and then declined. The GMFM‐88 score increased from the median baseline value of 51 to 66 (p=0.002) and 76 (p<0.001) at the initial follow‐ups. After 10 years there was a decline in gross motor function with a reduction in the GMFM‐88 score to 62 (p=0.022). Within 10 years, 16 out of 19 patients had a mean of three orthopaedic surgeries (SD 2.8), soft tissue surgery being the most common.
Interpretation The spasticity‐reducing effect of SDR, although pronounced, did not seem to improve long‐term functioning or prevent contractures. This suggests that contracture development in CP is not mediated by spasticity alone.</abstract><cop>Oxford, UK</cop><pub>Blackwell Publishing Ltd</pub><pmid>21585367</pmid><doi>10.1111/j.1469-8749.2011.03969.x</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Developmental medicine and child neurology, 2011-08, Vol.53 (8), p.724-729 |
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| source | Wiley Free Content; MEDLINE; Wiley Online Library Journals Frontfile Complete |
| subjects | Cerebral Palsy Cerebral Palsy - surgery Child Child, Preschool Children Disability Evaluation Female Followup Studies Gait Humans Longitudinal Studies Male Muscle Spasticity - etiology Orthopedic Procedures - methods Patients Physical Disabilities Postoperative Complications - etiology Psychomotor Skills Range of Motion, Articular Retrospective Studies Rhizotomy - adverse effects Severity of Illness Index Statistics as Topic Statistics, Nonparametric Surgery Time Factors Treatment Outcome |
| title | Does loss of spasticity matter? A 10‐year follow‐up after selective dorsal rhizotomy in cerebral palsy |
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