Assessment of upper-extremity function in children with spastic diplegia before and after selective dorsal rhizotomy

The upper-extremity function of 26 children (mean age 6.0 years) with spastic diplegia was assessed prior to and one year following selective dorsal rhizotomy (SDR). No significant change was found in upper extremity range of motion, muscle tone, or strength (MMT). A significant increase was noted in grasp strength bilaterally which could not be explained simply on the basis of maturation. Manipulation patterns were noted to improve significantly one year after SDR; however, this was proposed to be a maturation rather than intervention effect. Standardized test results revealed no significant improvement in functional hand use when the scores of children with spastic diplegia were compared with age-matched norms, to control for the effect of maturation. The significant improvement found in ability to toilet, dress and undress independently was most likely due to the effect of SDR on lower-extremity muscle tone. Further investigation with a matched control group would provide a conclusive result regarding the effect of SDR on upper extremity function and assist in understanding the maturation of hand function in children with spastic diplegia.