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Upper extremity performance and self-care skill changes in children with spastic cerebral palsy following selective
P Loewen1, P Steinbok, L Holsti
1Department of Occupational Therapy, British Columbia's Children's Hospital, University of British Columbia, Vancouver, B.C., Canada. ploewen@wpog.childhosp.bc.ca
Insights
Selective posterior rhizotomy (SPR) significantly improved upper extremity function and self-care skills in children with spastic cerebral palsy. Quantifiable gains in motor and cognitive abilities were observed one year post-surgery.
Area of Science:
- Neurology
- Pediatric Rehabilitation
- Neurosurgery
Background:
- Selective posterior rhizotomy (SPR) is a neurosurgical procedure.
- Its impact on upper extremity function and self-care in spastic cerebral palsy is often reported but not consistently quantified.
Purpose of the Study:
- To quantify changes in upper extremity function and self-care performance in children with spastic cerebral palsy one year after SPR.
Main Methods:
- 36 children with spastic cerebral palsy underwent assessment before and 1 year after SPR using the Quality of Upper Extremity Skills Test (QUEST).
- 26 children were assessed using the Functional Independence Measure for Children (WeeFIM) for self-care performance.
- Wilcoxon matched-pair signed-rank tests analyzed pre- and post-operative scores.
Main Results:
- Significant improvements were noted in total QUEST scores (median 3.2% increase, p < 0.0001).
- WeeFIM motor scores (median 9.5 increase, p < 0.0001), cognitive scores (median 1.0 increase, p < 0.008), and total scores (median 11.0 increase, p < 0.0001) also showed significant gains.
Conclusions:
- SPR leads to quantifiable improvements in upper extremity function in children with spastic cerebral palsy.
- The procedure also enhances motor and cognitive aspects of self-care skills one year post-intervention.
Abstract:
Changes in upper extremity and self-care performance following selective posterior rhizotomy (SPR) are reported frequently, but rarely quantified. In this study, 36 children with spastic cerebral palsy were assessed preoperatively and 1 year following SPR using the Quality of Upper Extremity Skills Test (QUEST). Twenty-six children were assessed at similar intervals using the Functional Independence Measure for Children (WeeFIM) as a measure of self-care performance. Wilcoxon matched-pair signed-rank tests were used to compare the QUEST total scores and the WeeFIM motor, cognitive, and total scores before and after SPR. One year after SPR, the total QUEST scores were significantly better (median improvement = 3.2%, p < 0.0001), as were the WeeFIM motor (median improvement = 9.5, p < 0. 0001), cognitive (median improvement = 1.0, p < 0.008), and total (median improvement = 11.0, p < 0.0001) scores. The results indicate quantifiable improvements in upper extremity function, and motor and cognitive self-care skills in children 1 year after SPR.