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Spasticity and strength changes as a function of selective dorsal rhizotomy
J R Engsberg1, K S Olree, S A Ross
1Human Performance Laboratory, Barnes-Jewish and St. Louis Children's Hospitals, Missouri 63108, USA. jre6264@bjcmail.carenet.org
Journal of Neurosurgery
|June 3, 1998
Summary
Selective dorsal rhizotomy reduced hamstring spasticity in children with cerebral palsy (CP). However, hamstring strength in the CP group significantly increased post-surgery, contrary to previous findings.
Area of Science:
- Neurology
- Pediatrics
- Rehabilitation Medicine
Background:
- Cerebral palsy (CP) often involves hamstring muscle spasticity.
- Selective dorsal rhizotomy (SDR) is a surgical intervention for CP.
- The impact of SDR on hamstring spasticity and strength requires further quantification.
Purpose of the Study:
- To quantify changes in hamstring muscle spasticity and strength in children with CP after SDR.
- To compare spasticity and strength measures between children with CP and able-bodied (AB) children.
Main Methods:
- Nineteen children with CP and six AB children were assessed using a dynamometer.
- Spasticity was measured by calculating the slope of work-velocity data during passive knee extension.
- Strength was measured by the work done during maximum concentric hamstring contractions.
Main Results:
- Pre-surgery, children with CP had significantly greater hamstring spasticity than AB children.
- Post-surgery, hamstring spasticity in the CP group was not significantly different from the AB group.
- Hamstring strength in the CP group significantly increased post-surgery but remained lower than in the AB group.
Conclusions:
- SDR effectively reduces hamstring spasticity in children with CP.
- Contrary to prior literature, SDR led to a significant increase in hamstring strength in this CP cohort.