Gross motor function change after multilevel soft tissue release in children with cerebral palsy

被引:18
作者
Chang, Chia-Hsieh [1 ,2 ]
Chen, Yu-Ying [2 ]
Yeh, Kuo-Kuang [3 ,4 ,5 ]
Chen, Chia-Ling [3 ,6 ]
机构
[1] Chang Gung Mem Hosp, Dept Pediat Orthoped, Linkou, Taiwan
[2] Cerebral Palsy Assoc Taoyuan, Taoyuan, Taiwan
[3] Chang Gung Mem Hosp, Dept Phys Med & Rehabil, Linkou, Taiwan
[4] Chang Gung Univ, Dept Phys Therapy, Taoyuan, Taiwan
[5] Chang Gung Univ, Coll Med, Graduat Inst Rehabil Sci, Taoyuan, Taiwan
[6] Chang Gung Univ, Coll Med, Grad Inst Early Intervent, Taoyuan, Taiwan
关键词
Cerebral palsy; Soft tissue release; Gross motor function; SPASTIC DIPLEGIA; PHYSICAL THERAPY; SURGERY; GAIT; RELIABILITY; INTERVENTION; MANAGEMENT; SYSTEM;
D O I
10.1016/j.bj.2016.12.003
中图分类号
Q5 [生物化学]; Q7 [分子生物学];
学科分类号
071010 ; 081704 ;
摘要
Background: Improving motor function is a major goal of therapy for children with cerebral palsy (CP). However, changes in motor function after orthopedic surgery for gait disorders are seldom discussed. This study aimed to evaluate the postoperative changes in gross motor function and to investigate the prognostic factors for such changes. Methods: We prospectively studied 25 children with CP (4-12 years) who were gross motor function classification system (GMFCS) level II to IV and and underwent bilateral multilevel soft-tissue release for knee flexion gait. Patients were evaluated preoperatively and at 6 weeks and 3 and 6 months postoperatively for Gross Motor Function Measure (GMFM-66), range of motion, spasticity, and selective motor control. The associations between change in GMFM-66 score and possible factors were analyzed. Results: 25 children with gross motor function level II to IV underwent surgery at a mean age of 8.6 years (range, 4-12 years). Mean GMFM-66 score decreased from 55.9 at baseline to 54.3 at 6-weeks postoperatively and increased to 57.5 at 6-months postoperatively (p < 0.05). Regression analysis revealed better gross motor function level and greater surgical reduction of spasticity were predictors for decreased GMFM-66 score at 6-weeks postoperatively. Younger age was a predictor for increased GMFM-66 score at 6-months postoperatively. Conclusion: Reduction of contracture and spasticity and improvement of selective motor control were noted after surgery in children with CP. However, a down-and-up course of GMFM-66 score was noted. It is emphasized that deterioration of motor function in children with ambulatory ability and the improvement in young children after orthopedic surgery for gait disorders.
引用
收藏
页码:163 / 168
页数:6
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