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Clinical functional outcome measures for children with cerebral palsy after gait corrective orthopaedic surgery: A
Maxine M Fong1,2, Noula Gibson1,2,3, Sian A Williams1,4
1Curtin School of Allied Health, Curtin University, Perth, Western Australia, Australia.
Insights
The Edinburgh Visual Gait Scale (EVGS) and Functional Mobility Scale (FMS) are recommended for assessing children with cerebral palsy (CP) post-surgery. A clear participation measure is needed for comprehensive outcomes in pediatric orthopedic gait surgery.
Area of Science:
- Orthopedics
- Pediatric Rehabilitation
- Movement Science
Background:
- Cerebral palsy (CP) significantly impacts gait, activity, and participation in children.
- Gait corrective orthopedic surgery aims to improve functional outcomes in pediatric CP.
- Standardized outcome measures are crucial for evaluating surgical effectiveness.
Purpose of the Study:
- To identify the most frequently reported non-instrumented measures of gait, activity, and participation in children with CP post-orthopedic surgery.
- To inform the development of a comprehensive outcome assessment framework.
Main Methods:
- A systematic literature search was conducted across four databases up to December 2021.
- Studies evaluating functional outcomes in children (<18 years) with CP undergoing gait corrective surgery were included.
- Data from eligible publications were extracted and analyzed to determine the frequency of outcome measure usage.
Main Results:
- 44 publications involving 3535 children with CP (GMFCS levels I-III) were analyzed.
- Fourteen different outcome measures were identified: 1 gait (Edinburgh Visual Gait Scale - EVGS), 10 activity (Functional Mobility Scale - FMS most common), and 3 participation measures.
- No studies reported a combined assessment of gait, activity, and participation.
Conclusions:
- The EVGS and FMS are recommended as core outcome measures for gait corrective orthopedic surgery in children with CP.
- A clear, standardized measure for participation is needed.
- Future research should focus on developing a comprehensive suite of outcomes meaningful to clinicians and families.
Aim:
To identify the most frequently reported non-instrumented measures of gait, activity, and participation in children with cerebral palsy (CP) after undergoing gait corrective orthopaedic surgery.
Method:
Four databases were searched from database inception to the 9th December 2021 for studies that evaluated functional outcomes for children with CP under 18 years undergoing gait corrective orthopaedic surgery.
Results:
Of 547 citations, 44 publications (n = 3535 participants, n = 1789 males, mean age 10 years 5 months [SD = 3 years 3 months], Gross Motor Function Classification System levels I-III at the time of surgery) were eligible for inclusion. Fourteen different outcome measures were used: one measure of gait, 10 measures of activity, and three measures of participation. Gait was measured with the Edinburgh Visual Gait Scale (EVGS; 4 out of 44). The most common activity and participation measures were the Functional Mobility Scale (FMS; 15 out of 44) and Pediatric Outcomes Data Collection Instrument (11 out of 44) respectively. No studies reported a combination of gait, activity, and participation measures.
Interpretation:
The EVGS and FMS should be considered as core outcome measures in gait corrective orthopaedic surgery, while a measure of participation is unclear. Additional considerations for developing a comprehensive suite of outcomes include identifying a combination of clinical measures and performance-reflective questionnaires that are standardized for children with CP undergoing surgery and meaningful to clinicians and families.
