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Effectiveness of selective muscle-release surgery for children with cerebral palsy: longitudinal and stratified
Izumi Kondo1, Kanoko Hosokawa, Manabu Iwata
1Rehabilitation Centre, Hirosaki University Hospital, 53 Honchou, Hirosaki, 036-8563, Japan. noukenrk@cc.hirosaki-u.ac.jp
Insights
Muscle-release surgery significantly improves motor function in children with cerebral palsy (CP), particularly those with GMFCS levels III and IV. This study tracked 25 children over 12 months post-surgery.
Area of Science:
- Orthopedic Surgery
- Pediatric Neurology
- Rehabilitation Medicine
Background:
- Cerebral palsy (CP) is a group of movement disorders affecting muscle tone and posture.
- Muscle-release surgery is a potential intervention to improve motor function in children with CP.
- The Gross Motor Function Classification System (GMFCS) categorizes CP severity, guiding treatment decisions.
Purpose of the Study:
- To evaluate the effectiveness of muscle-release surgery in enhancing motor function for children with cerebral palsy (CP).
- To analyze surgical outcomes longitudinally and in stratified groups based on GMFCS levels.
- To determine if specific GMFCS levels benefit more from this surgical intervention.
Main Methods:
- A longitudinal study involving 25 children (aged 4-16 years) with CP undergoing muscle-release surgery.
- Motor function was assessed using the Gross Motor Function Measure (GMFM) at eight time points: pre-surgery and up to 12 months post-surgery.
- Participants were classified using the Gross Motor Function Classification System (GMFCS) levels I-IV.
Main Results:
- Significant improvements in GMFM scores were observed post-surgery in children classified at GMFCS levels III and IV (p<0.05).
- GMFM score improvements at 12 months post-surgery were 1, 5, 8.5, and 8.5 for GMFCS levels I, II, III, and IV, respectively.
- The data indicates a notable positive impact of muscle-release surgery on motor function for children in higher GMFCS levels.
Conclusions:
- Muscle-release surgery is an effective treatment for improving motor function in children with cerebral palsy, especially those in GMFCS levels III and IV.
- The study highlights the importance of GMFCS classification in predicting surgical outcomes.
- Further research can explore long-term effects and refine surgical techniques for different CP subtypes.
Abstract:
The purpose of this study was to determine the effectiveness of muscle-release surgery for children with cerebral palsy (CP) using longitudinal and stratified analysis. Twenty-five children with CP (15 females, 10 males; age range 4 to 16 years; mean age 8 years 2 months, SD 3 years 2 months) were selected from five treatment centres in Japan. Twenty-two children had spastic diplegia, two had spastic quadriplegia, and one had athetospastic quadriplegia. Motor function for each child was assessed using the Gross Motor Function Measure (GMFM). Assessment was conducted on eight separate occasions: 1 month and 1 week before surgery, and 1, 2, 4, 6, 9, and 12 months after surgery. Participants' motor function before surgery was classified using the Gross Motor Function Classification System (GMFCS). Six children were classified at level I, three at level II, six at level III, and 10 at level IV. A significant difference was found after surgery in the GMFCS levels III and IV groups (p<0.05). Improvement in GMFM scores between 1 week before surgery and 12 months after surgery were 1, 5, 8.5, and 8.5 for GMFCS levels I to IV respectively. Results indicate that this treatment is advantageous for improving motor function in children within GMFCS levels III and IV.
