No abstract

Purpose: To examine the role of multiple factors, including therapy dose, on recovery of mobility function during post–single-event multilevel surgery (SEMLS) rehabilitation in youth with cerebral palsy. Methods: Several factors expected to influence postoperative change in Gross Motor Function Measure (GMFM) were examined: age, Gross Motor Function Classification System (GMFCS) level, cognition, number of osteotomies, surgical complications, medical comorbidities, number of therapy sessions, and preoperative measures of gait, balance, and gross motor function. Results: Sixty-nine youth with cerebral palsy, GMFSC levels I-IV, who had undergone SEMLS and rehabilitation had on average 2.6 osteotomies and 89 postoperative therapy sessions. Fewer osteotomies, higher therapy dose, higher preoperative GMFM, and lower GMFM at postoperative admission were significant in determining GMFM change. Conclusions: The most relevant factors on post-SEMLS recovery were therapy dose, surgical burden, and level of gross motor function immediately before and after surgery.

Cerebral palsy (CP) comprises a group of disorders with impairments of movement and posture due to non-progressive disturbances in the developing fetal or infant brain. 1 Children with CP develop gait deviations and functional impairment associated with muscle contractures and bony deformities, spasticity, limited motor control, decreased strength and balance, and delayed acquisition of gross motor skills. 2 Gait deviation can increase the energy cost of walking, 3 causing fatigue 4 and frequent joint pains, 5 resulting in a decrease in walking activity.Walking activity is quantified by counting the number of strides per day, which can be accomplished using a variety of activity monitors. Walking activity is an important outcome measure that aligns with the World Health Organization's International Classification of Function, Disability and Health: Children and Youth Version. 6 This classification system defines body structures, body function, activities and participation, and environmental factors as components of health and well-being. 6 Walking activity is associated with health-related physical fitness, 7 and children with CP have been reported to have decreased low-, medium-, and high-intensity walking activity (measured by strides per day) compared with typically developing adolescents. 8 Walking activity is associated with