Evolution of walking ability after soft tissue surgery in cerebral palsy patients: what can we expect?

Abstract

Eleven patients with spastic cerebral palsy were evaluated preoperatively, and 3 and 9 months postoperatively after soft tissue surgery. Evaluation included clinical examination, the Functional Mobility Scale questionnaire, and instrumented gait and center of mass trajectory analysis. A decrease in time-distance parameters after 3 months was followed by progress in all parameters at 9 months postoperatively. Push-off range of ankle motion decreased after surgery and was not restored to preoperative level until 9 months later. The center of mass vertical displacement improved significantly. The Functional Mobility Scale showed gait improvement. Despite the normalization of range of motion after surgery, there is an obvious period of functional gait deterioration in the early postoperative period and the push-off range of motion at the ankle did not recover to preoperative level until 9 months later.

Ankle Dorsiflexor Function after Gastrocsoleus Lengthening in Children with Cerebral Palsy: A Literature Review

“…The remaining 223 articles were screened via full text independently by the authors (N.S., E.R.). Thirty-three articles appropriately met the inclusion criteria and were included in this review [ 11 , 12 , 19 , 20 , 21 , 22 , 23 , 25 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 ]. Further details regarding conditions for exclusion and the final number of included studies are represented by the PRISMA diagram in Figure 1 .…”

“…All 33 studies involved GSL for the management of equinus deformity in children or adolescents with CP [ 11 , 12 , 19 , 20 , 21 , 22 , 23 , 25 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 ]. Four studies also included data from adults [ 28 , 29 , 30 , 43 ].…”

“…These were deemed appropriate for this review as a majority of the cohorts included participants under 18 years of age. Twenty-nine studies [ 11 , 12 , 19 , 20 , 21 , 22 , 23 , 25 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 ] focused on GSL, either used as an isolated procedure or as part of MLS ( Table S1 , Supplementary Materials ). Four studies [ 28 , 29 , 30 , 31 ] investigated outcomes of TATS, used in combination with GSL ( Table S2 , Supplementary Materials ).…”

“…Four studies [ 28 , 29 , 30 , 31 ] investigated outcomes of TATS, used in combination with GSL ( Table S2 , Supplementary Materials ). All were cohort studies, reporting original data [ 11 , 12 , 19 , 20 , 21 , 22 , 23 , 25 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 ]. Seven were prospective studies [ 12 , 25 , 30 , 37 , 48 , 49 , 50 ].…”

“…All were cohort studies, reporting original data [ 11 , 12 , 19 , 20 , 21 , 22 , 23 , 25 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 ]. Seven were prospective studies [ 12 , 25 , 30 , 37 , 48 , 49 , 50 ]. Nineteen were retrospective studies [ 19 , 21 , 22 , 23 , 28 , 29 , 31 , 32 , 33 , 34 , 35 , 38 , 39 , 40 , 43 , 44 …”