Long-term outcome of children with cerebral palsy undergoing selective dorsal rhizotomy

Research output: ThesisDoctoral Thesis (compilation)

Abstract

The overall aim of the thesis was to describe long-term development of functional outcomes in children with cerebral palsy undergoing selective dorsal rhizotomy (SDR) combined with physiotherapy and to evaluate measures used in follow-up.

Five years after SDR muscle tone was reduced, passive range of motion (PROM) increased in hip, knee and foot, gross motor function measured by the Gross Motor Function Measure (GMFM) improved as well as functional performance and independence by the Pediatric Evaluation Disability Inventory. SDR was safe and effective. Combined with physiotherapy, SDR provided lasting functional benefits (Paper I).

In Paper II the amount and types of orthopaedic surgery five years after SDR were analyzed. Subtalar arthrodesis, achilles and adductor tendon lengthening were the most frequent operations, 42% of the children had undergone orthopaedic surgery.

In Paper III the longitudinal construct validity (LCV) of different GMFM scores was studied. Large Effect Size and Standardized Response Mean at 12 months were seen for GMFM-88 and GMFM-66 scores at later follow-ups. All scores showed large LCV during the 5-year follow-up.

Changes in gait pattern in three dimensional gait analyses during 5 years were shown by Gait Profile Score and Movement Assessment Profile. The instruments were found to be useful for longitudinal studies (Paper IV).

Changes in functional outcomes between pre- and 10 years after SDR were described and factors explaining the changes were identified. Muscle tone was reduced, PROM was similar to preoperative measurements and GMFM-66 improved. Changes were related to levels of severity and age (Paper V).

Details

Authors
  • Annika Lundkvist
Organisations
Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Physiotherapy

Keywords

  • selective dorsal rhizotomy, outcomes, long-term follow-up, Cerebral palsy, children, function, physiotherapy
Original languageEnglish
QualificationDoctor
Awarding Institution
Supervisors/Assistant supervisor
  • GUN-BRITT M JARNLO, Supervisor
  • Eva Nordmark, Supervisor
  • Lena Westbom, Supervisor
Award date2010 May 6
Publisher
  • Lund University
Print ISBNs978-91-86443-56-6
Publication statusPublished - 2010
Publication categoryResearch

Bibliographic note

Defence details Date: 2010-05-06 Time: 13:00 Place: Aulan, Skåne University Hospital, Getingevägen 4, Lund, Sweden External reviewer(s) Name: Brogren Carlberg, Eva Title: Associate professor Affiliation: Dept of Women's and Children's Health, Karolinska Institutet, Neuropediatric Research Unit, Astrid Lindgren Children's hospital, Stockholm, Sweden --- The information about affiliations in this record was updated in December 2015. The record was previously connected to the following departments: Division of Physiotherapy (Closed 2012) (013042000)

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Related research output

Annika Lundkvist Josenby, Gun-Britt Jarnlo, Christina Gummesson & Eva Nordmark, 2009, In: Physical Therapy. 89, 4, p. 342-350

Research output: Contribution to journalArticle

Eva Nordmark, Annika Lundkvist, Jan Lagergren, Gert Andersson, Lars-Göran Strömblad & Lena Westbom, 2008, In: BMC Pediatrics. 8, 54.

Research output: Contribution to journalArticle

Annika Lundkvist & Gunnar Hägglund, 2006, In: Journal of Pediatric Orthopedics. Part B. 15, 4, p. 244-246

Research output: Contribution to journalArticle

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