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Quality of Movement Changes in Ambulatory Children with Cerebral Palsy 1 Year after Selective Dorsal Rhizotomy
Deepti Chugh1,2, Stephanie P Cawker2, Lesley Katchburian1
1From the:Department of Neurodisability, Great Ormond Street Hospital, London, United Kingdom.
Insights
Selective dorsal rhizotomy (SDR) surgery significantly improved the quality of movement in children with cerebral palsy. This enhancement was observed across all measured movement attributes one year post-operation.
Area of Science:
- Pediatric Orthopedics
- Neurorehabilitation
- Movement Science
Background:
- Quality of movement is crucial for gross motor function in children with cerebral palsy.
- Selective Dorsal Rhizotomy (SDR) is a surgical intervention aimed at improving motor function.
- The Quality Function Measure (QFM) assesses specific attributes of movement quality.
Purpose of the Study:
- To evaluate the impact of SDR on the quality of gross motor movement in ambulatory children with cerebral palsy.
- To assess changes in QFM attributes one year after SDR surgery.
- To provide evidence supporting the use of SDR in children with cerebral palsy.
Main Methods:
- Retrospective study with a single-group repeated measure design.
- 48 ambulatory children with cerebral palsy (GMFCS levels II and III) were evaluated.
- Quality of movement was measured using the Quality Function Measure (QFM) pre- and post-surgery.
Main Results:
- All five QFM attributes (Alignment, Coordination, Dissociated Movements, Stability, Weight-shift) showed significant improvement (p < 0.001) after SDR.
- Improvements ranged from 9.02% for Stability to 26.5% for Alignment.
- Positive outcomes were consistent across both GMFCS levels II and III.
Conclusions:
- SDR combined with rehabilitation is associated with enhanced quality of gross motor movement in children with cerebral palsy.
- The findings offer further support for the efficacy of SDR in this patient population.
- Future research should explore the functional and participation outcomes related to improved movement quality post-SDR.
Abstract:
Purpose: Quality of movement is an important component of effective gross motor performance in children with cerebral palsy. This study used the Quality Function Measure (QFM) to evaluate changes in quality of movement in ambulatory children with cerebral palsy 1 year after selective dorsal rhizotomy (SDR). Method: In a retrospective study, using a single-group repeated measure design, 48 children (28 male) at preoperative Gross Motor Function Classification System (GMFCS) level II (n = 18) and III (n = 30) were evaluated. Mean (standard deviation) age at surgery was 7 years 11 months (2 years 3 months). Scores for all five QFM attributes, Alignment, Coordination, Dissociated Movements, Stability and Weight-shift were obtained. Results: All QFM attributes improved significantly (p < 0.001) for all children and within both GMFCS levels. Mean (SD) change in QFM scores varied from 9.02% (8.61) for Stability to 26.5% (22.06) for Alignment. Conclusions: SDR and subsequent rehabilitation are associated with an improvement in the quality of gross motor movement in children with cerebral palsy. This study provides clinicians and families with further evidence supporting the value of SDR in this population. Further studies need to evaluate the impact of improved quality of movement on a child's function and participation in the real world.
