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Effectiveness of selective muscle-release surgery for children with cerebral palsy: longitudinal and stratified analysis

Published online by Cambridge University Press:  27 July 2004

Izumi Kondo ,
Kanoko Hosokawa ,
Manabu Iwata ,
Atsushi Oda ,
Tadao Nomura ,
Keiichi Ikeda ,
Yoshimi Asagai ,
Tomokazu Kohzaki  and
Hitoshi Nishimura
Izumi Kondo
Affiliation:
Rehabilitation Centre, Hirosaki University, Hirosaki, Japan.
Kanoko Hosokawa
Affiliation:
Rehabilitation Centre, Hirosaki University, Hirosaki, Japan.
Manabu Iwata
Affiliation:
Department of Physical Therapy, School of Health Sciences, Hirosaki University, Hirosaki, Japan.
Atsushi Oda
Affiliation:
Department of Physical Therapy, School of Health Sciences, Hirosaki University, Hirosaki, Japan.
Tadao Nomura
Affiliation:
Koshi Rehabilitation Hospital, Toyama, Japan.
Keiichi Ikeda
Affiliation:
Department of Orthopaedic Surgery, Rehabilitation Centre for Disabled Children, Kumamoto Prefecture, Japan.
Yoshimi Asagai
Affiliation:
Shinano Handicapped Children's Hospital, Shimosuwachou, Japan.
Tomokazu Kohzaki
Affiliation:
Department of Orthopaedic Surgery, Tochigi Rehabilitation Centre, Utunomiya, Japan.
Hitoshi Nishimura
Affiliation:
Ishikawa Seishi Gakuen, Hospital and Home for Handicapped Children, Kanazawa, Japan.
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Abstract

The purpose of this study was to determine the effectiveness of muscle-release surgery for children with cerebral palsy (CP) using longitudinal and stratified analysis. Twenty-five children with CP (15 females, 10 males; age range 4 to 16 years; mean age 8 years 2 months, SD 3 years 2 months) were selected from five treatment centres in Japan. Twenty-two children had spastic diplegia, two had spastic quadriplegia, and one had athetospastic quadriplegia. Motor function for each child was assessed using the Gross Motor Function Measure (GMFM). Assessment was conducted on eight separate occasions: 1 month and 1 week before surgery, and 1, 2, 4, 6, 9, and 12 months after surgery. Participants' motor function before surgery was classified using the Gross Motor Function Classification System (GMFCS). Six children were classified at level I, three at level II, six at level III, and 10 at level IV. A significant difference was found after surgery in the GMFCS levels III and IV groups (p<0.05). Improvement in GMFM scores between 1 week before surgery and 12 months after surgery were 1, 5, 8.5, and 8.5 for GMFCS levels I to IV respectively. Results indicate that this treatment is advantageous for improving motor function in children within GMFCS levels III and IV.

Type
Original Articles
Information
Developmental Medicine and Child Neurology , Volume 46 , Issue 8 , August 2004 , pp. 540 - 547
Copyright
© 2004 Mac Keith Press

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