Energy consumption does not change after selective dorsal rhizotomy in children with spastic cerebral palsy

Area of Science:

• Neurology
• Pediatrics
• Rehabilitation Medicine

Background:

• Cerebral palsy (CP) is a common childhood neurological disorder affecting movement.
• Energy consumption during walking is a significant concern for children with CP.
• Selective dorsal rhizotomy (SDR) is a surgical intervention aimed at reducing spasticity in CP.

Purpose of the Study:

• To investigate the impact of selective dorsal rhizotomy (SDR) on energy consumption during walking in children with bilateral spastic cerebral palsy (CP).
• To compare changes in energy consumption and walking parameters in children with CP who underwent SDR versus a matched control group.

Main Methods:

• A retrospective study evaluated 101 children with bilateral spastic CP who underwent SDR, compared to a matched control group not receiving SDR.
• Energy consumption during walking was assessed using net nondimensional measures at baseline and follow-up (mean 1.7 years post-intervention).
• Groups were matched for age, spasticity, and baseline energy consumption.

Main Results:

• The SDR group experienced significantly greater spasticity reduction (-42%) compared to controls (-20%).
• Both groups showed modest decreases in energy consumption (-12% SDR, -7% control), with no significant difference between them.
• There was no significant difference in the change in walking speed between the SDR and control groups.

Conclusions:

• Selective dorsal rhizotomy (SDR) did not lead to greater reductions in energy consumption during walking compared to natural age-related changes in children with CP.
• The significant reduction in spasticity following SDR suggests spasticity may have a minimal direct impact on energy consumption during walking in this population.
• These findings highlight the importance of matched control groups in CP research to account for developmental changes in energy consumption and spasticity.