Role of femoral derotation on gait after selective dorsal rhizotomy in children with spastic cerebral palsy

Campenhout, Anja Van; Huenaerts, Catherine; Poulussen, Liesbeth; Prinsen, Sandra; Desloovere, Kaat

doi:10.1111/dmcn.14192

Cited by 8 publications

(13 citation statements)

References 24 publications

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“…All three-dimensional kinematic data were captured using a Codamotion active marker system (Charnwood Dynamics, Leicestershire, UK) using a modified Helen Hayes protocol at a capture rate of 200Hz [11]. Due to the central nature of SDR both limbs were included as per Van Campenhout et al [12]. As the pelvis is a single unit, kinematics of one side only were included in the analysis.…”

Section: Methodsmentioning

confidence: 99%

The short-term effects of selective dorsal rhizotomy on gait compared to matched cerebral palsy control groups

O’Sullivan¹,

Leonard²,

Quinn³

et al. 2019

PLoS ONE

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Objectives To examine the short-term effects of selective dorsal rhizotomy (SDR) ± soft-tissue surgery on gait in cerebral palsy (CP) compared to matched controls with no surgical intervention. Methods Participants had gait analysis before and one year after SDR. Non SDR participants were retrospectively matched for age and all significant gait parameters. The SDR group was further subdivided into those who had concomitant orthopaedic surgery and those who had SDR only. Results The SDR group consisted of 29 participants (mean age 5.8 years at baseline, 7.7 years at follow-up). Of these, 13 had concomitant orthopaedic surgery. The non SDR group consisted of 18 participants (mean age at baseline 6.1 years, 8.1 years at follow-up). SDR ± soft-tissue surgery significantly improved step-lengths, knee flexion at initial contact and mid-stance, ankle dorsiflexion, foot progression and timing of peak knee flexion. None of these improvements in gait were seen without surgical intervention. While more improvements were seen in those who had SDR and orthopaedic surgery, SDR only resulted in improved step-lengths, knee extension, foot progression and timing of peak knee flexion. Conclusions SDR ± soft-tissue surgery results in short-term improvements in gait which are not seen without surgical intervention. While those who had SDR and soft-tissue surgery demonstrated more changes in gait, many improvements were attributable to SDR only.

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Section: Methodsmentioning

confidence: 99%

The short-term effects of selective dorsal rhizotomy on gait compared to matched cerebral palsy control groups

O’Sullivan¹,

Leonard²,

Quinn³

et al. 2019

PLoS ONE

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show abstract

“…Further, the data from two reference groups were used: patients who only received SDR and a patient group who underwent SDR after FDO in an earlier stage. These retrospective control data were obtained from a previous study in our center on the outcome of SDR and/or FDO [12].…”

Section: Study Design Participants and Data Collectionmentioning

confidence: 99%

“…Strict selection criteria for SDR are essential. Although lacking an international consensus, most clinicians agree that a good candidate is a child with bilateral spastic CP with high spasticity in lower limb muscles, possessing enough selective motor control and strength [12].…”

Section: Gait Analysismentioning

confidence: 99%

Simultaneous femoral derotation osteotomy and selective dorsal rhizotomy in children with spastic cerebral palsy: A prospective follow-up of 3 cases

Schreurs¹,

Huenaerts²,

Desloovere³

et al. 2021

Clin Case Studie Rep

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Cerebral palsy (CP) refers to a group of neurodevelopmental disorders characterized by permanent motor impairment, sometimes associated with comorbidities, such as seizures, intellectual disability, speech, visual and hearing difficulties. It is caused by lesions in the developing brain that occur before, during or in the first two years after birth. CP is the most common cause for disability in children [1,2]. Different neuromotor types of CP are described, with the bilateral spastic subtype as the most frequent manifestation [3]. Spasticity is an important clinical aspect that affects motion patterns and muscular control. Furthermore, it is generally considered to be a crucial contributor to functional limitations, discomfort and gait abnormalities [4]. The supposed pathophysiology is an excessive afferent input onto intramedullary neurons without the expected inhibitory signals from the corticospinal tract, which is disrupted in case of CP associated cerebral

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“…A better alignment increased the hip abduction and extension moment during gait, which did not only result in a better gait, but likely also provided a more optimal position for the physical therapist to train hip extension and abduction. 105…”

Section: Mode Of Actionmentioning

confidence: 99%

Tone Reduction and Physical Therapy: Strengthening Partners in Treatment of Children with Spastic Cerebral Palsy

et al. 2019

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The aim of this paper is to provide a clinically applicable overview of different tone reducing modalities and how these can interact with or augment concurrent physical therapy (PT). Botulinum toxin (BoNT), oral tone-regulating medication, intrathecal baclofen (ITB), and selective dorsal rhizotomy are discussed within a physiotherapeutic context and in view of current scientific evidence. We propose clinical reasoning strategies to identify treatment goals as well as the appropriate and corresponding treatment interventions. Instrumented measurement of spasticity, standardized clinical assessment, and 3D clinical motion analysis are scientifically sound tools to help select the appropriate treatment and, when needed, to selectively target or spare individual muscles. In addition, particular attention is given to strength training as a necessary tool to tackle muscle weakness associated with specific modalities of tone reduction. More research is needed to methodologically assess the long-term effectiveness of such individualized tone treatment, optimize parameters such as medication dosage, and gain more insight into the kind of PT techniques that are essential in conjunction with tone reduction.

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Role of femoral derotation on gait after selective dorsal rhizotomy in children with spastic cerebral palsy

Cited by 8 publications

References 24 publications

The short-term effects of selective dorsal rhizotomy on gait compared to matched cerebral palsy control groups

The short-term effects of selective dorsal rhizotomy on gait compared to matched cerebral palsy control groups

Simultaneous femoral derotation osteotomy and selective dorsal rhizotomy in children with spastic cerebral palsy: A prospective follow-up of 3 cases

Tone Reduction and Physical Therapy: Strengthening Partners in Treatment of Children with Spastic Cerebral Palsy

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