Evolution of self‐care and functional mobility after single‐event multilevel surgery in children and adolescents with spastic diplegic cerebral palsy

Dequeker, Griet; Campenhout, Anja Van; Feys, Hilde; Molenaers, Guy

doi:10.1111/dmcn.13683

Cited by 26 publications

(39 citation statements)

References 19 publications

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“…Functional abilities were assessed with the Functional Mobility Scale (FMS), 23 the Lower Extremity Functional Scale (LEFS), 24 and the Posture and Postural Ability Scale (PPAS). 25 The FMS measures functional mobility and walking capacity (W) using a six-level classification system with higher scores indicating better motor functioning.…”

Section: Measurementsmentioning

confidence: 99%

PredictMed: A Machine Learning Model for Identifying Risk Factors of Neuromuscular Hip Dysplasia: A Multicenter Descriptive Study

et al. 2020

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Neuromuscular hip dysplasia (NHD) is a common and severe problem in patients with cerebral palsy (CP). Previous studies have so far identified only spasticity (SP) and high levels of Gross Motor Function Classification System as factors associated with NHD. The aim of this study is to develop a machine learning model to identify additional risk factors of NHD. This was a cross-sectional multicenter descriptive study of 102 teenagers with CP (60 males, 42 females; 60 inpatients, 42 outpatients; mean age 16.5 ± 1.2 years, range 12–18 years). Data on etiology, diagnosis, SP, epilepsy (E), clinical history, and functional assessments were collected between 2007 and 2017. Hip dysplasia was defined as femoral head lateral migration percentage > 33% on pelvic radiogram. A logistic regression-prediction model named PredictMed was developed to identify risk factors of NHD. Twenty-eight (27%) teenagers with CP had NHD, of which 18 (67%) had dislocated hips. Logistic regression model identified poor walking abilities (p < 0.001; odds ratio [OR] infinity; 95% confidence interval [CI] infinity), scoliosis (p = 0.01; OR 3.22; 95% CI 1.30–7.92), trunk muscles' tone disorder (p = 0.002; OR 4.81; 95% CI 1.75–13.25), SP (p = 0.006; OR 6.6; 95% CI 1.46–30.23), poor motor function (p = 0.02; OR 5.5; 95% CI 1.2–25.2), and E (p = 0.03; OR 2.6; standard error 0.44) as risk factors of NHD. The accuracy of the model was 77%. PredictMed identified trunk muscles' tone disorder, severe scoliosis, E, and SP as risk factors of NHD in teenagers with CP.

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Section: Measurementsmentioning

confidence: 99%

PredictMed: A Machine Learning Model for Identifying Risk Factors of Neuromuscular Hip Dysplasia: A Multicenter Descriptive Study

et al. 2020

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“…Consequently, different evaluation scales have their limitations. The clinically feasible tool for quantifying change after orthopedic surgery in CP should be selected based on the characteristics of distinct evaluation scales [47, 48].…”

Section: Surgical Managementmentioning

confidence: 99%

Orthopedic treatment of the lower limbs in spastic paralysis

Deng

Zeng

et al. 2020

Brain Science Advances

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Spastic paralysis of the limb mainly results from the central lesion, in which spastic cerebral palsy is the common cause. Due to durative muscle spasm in spastic cerebral palsy, it is often accompanied by the formation of secondary musculoskeletal deformities, resulting in limb motor disability. Based on its pathogenesis, surgical treatment is currently applied: selective posterior rhizotomy (SPR) or orthopedic surgery. The primary purpose of early orthopedic surgery was simply to correct limb deformities, which usually led to the recurrence of deformity as a result of the presence of spasticity. With the application of SPR, high muscle tone was successfully relieved, but limb deformity was still present postoperatively. Therefore, this study aimed to elaborate on the management of orthopedic surgery, common deformities of the lower limb, and orthopedic operative methods; discuss the relationship between SPR and orthopedic procedure for limb deformity; and focus on the indications, timing of intervention, and postoperative outcome of different surgical methods.

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“…5 É relatada na literatura uma forte relação entre o prognóstico positivo da cirurgia sobre a funcionalidade e a idade da criança quando é realizada: quanto melhor a funcionalidade, mais precoce é a cirurgia necessária para otimizar seu desenvolvimento motor. 3,6 Estudos mostram o efeito benéfico da cirurgia multinível na criança com PC. 1,[7][8][9][10] No Brasil, entretanto, não há garantia de que as crianças receberão intervenções baseadas em evidências em tempo hábil, devido às barreiras para sua implementação na prática clínica sistematizada no Sistema Único de Saúde (SUS), pois ainda existe um distanciamento entre a pesquisa e a prática clínica.…”

Section: Introductionunclassified

Functioning of a child with bilateral cerebral palsy submitted to multilevel surgery: case report

Rosa

Valenzuela²,

Defilipo

et al. 2021

Rev Pesq Fisio

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INTRODUCTION: Interventions in different joints may be necessary to correct crouch gait and others musculoskeletal changes that occur as time passes for Cerebral Palsy (CP) children. Multilevel surgery reduces the number of hospitalizations, contributes to the prevention of secondary disabilities, and improves ambulation ability of children with diplegia. OBJECTIVE: Document the changes in mobility outcomes of a bilateral CP child, type diplegia, child after lower limbs multilevel surgery in the Brazilian context MATERIAL AND METHODS: The participant was an eight-year-old girl, Gross Motor Function Classification System level III. The mother signed the informed consent form. The Gross Motor Function Measure–66 (GMFM-66) was performed one day before surgery and one, three, six and twelve months after surgery. To complete the child’s evolution records, additional information was obtained through the electronic system of the hospital. RESULTS: The GMFM-66 total score was: 49.6 pre-operative (CI95%: 47.3-51.9); 42.8 after one month (CI95%: 40.7-45.0); 49.9 after three months (CI95%: 47.6-52.1); 52.6 after six months (CI95%: 50.2-55.0) and 56.9 after one year (CI95%: 54.6-59.2), increasing after 6 months of surgery (*p<0.05). The participant presented satisfactory adherence to physiotherapy. CONCLUSION: This study describes the case of a Brazilian child with CP, using the public health system. The impact of multilevel surgery was predominant in mobility, with worsening of capacity soon after surgery and progressive improvement over the months. Factors that may have contributed to our results were adherence, frequency, contextual factors.

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Evolution of self‐care and functional mobility after single‐event multilevel surgery in children and adolescents with spastic diplegic cerebral palsy

Cited by 26 publications

References 19 publications

PredictMed: A Machine Learning Model for Identifying Risk Factors of Neuromuscular Hip Dysplasia: A Multicenter Descriptive Study

PredictMed: A Machine Learning Model for Identifying Risk Factors of Neuromuscular Hip Dysplasia: A Multicenter Descriptive Study

Orthopedic treatment of the lower limbs in spastic paralysis

Functioning of a child with bilateral cerebral palsy submitted to multilevel surgery: case report

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