Long‐term effects of spasticity treatment, including selective dorsal rhizotomy, for individuals with cerebral palsy

Aim To understand the long‐term effects of comprehensive spasticity treatment, including selective dorsal rhizotomy (SDR), on individuals with spastic cerebral palsy. Method This was a pre‐registered, multicenter, retrospectively matched cohort study. Children were matched on age range and spasticit...

Full description

Saved in:
Bibliographic Details
Published in:Developmental medicine and child neurology 2022-05, Vol.64 (5), p.561-568
Main Authors: MacWilliams, Bruce A, McMulkin, Mark L, Duffy, Elizabeth A, Munger, Meghan E, Chen, Brian Po‐Jung, Novacheck, Tom F, Schwartz, Michael H, Carroll, Kristen L, Stotts, Alan K, Carter, Lisa H, Mader, Shelley L, Hayes, Brianna, Baird, Glen O
Format: Article
Language:English
Subjects:
Adult
Cerebral Palsy - complications
Cerebral Palsy - surgery
Child
Cohort Studies
Humans
Muscle Spasticity - drug therapy
Muscle Spasticity - etiology
Muscle Spasticity - surgery
Quality of Life
Retrospective Studies
Rhizotomy - adverse effects
Treatment Outcome
Young Adult
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Aim To understand the long‐term effects of comprehensive spasticity treatment, including selective dorsal rhizotomy (SDR), on individuals with spastic cerebral palsy. Method This was a pre‐registered, multicenter, retrospectively matched cohort study. Children were matched on age range and spasticity at baseline. Children at one center underwent spasticity treatment including SDR (Yes‐SDR, n=35) and antispastic injections. Children at two other centers had no SDR (No‐SDR, n=40 total) and limited antispastic injections. All underwent subsequent orthopedic treatment. Participants returned for comprehensive long‐term assessment (age ≥21y, follow‐up ≥10y). Assessment included spasticity, contracture, bony alignment, strength, gait, walking energy, function, pain, stiffness, participation, and quality of life. Results Spasticity was effectively reduced at long‐term assessment in the Yes‐SDR group and was unchanged in the No‐SDR group. There were no meaningful differences between the groups in any measure except the Gait Deviation Index (Yes‐SDR + 11 vs No‐SDR + 5) and walking speed (Yes‐SDR unchanged, No‐SDR declined 25%). The Yes‐SDR group underwent more subsequent orthopedic surgery (11.9 vs 9.7 per individual) and antispastic injections to the lower limbs (14.4 vs
ISSN:0012-1622
1469-8749
DOI:10.1111/dmcn.15075