OBJECTIVE: To compare the efficacy of selective dorsal rhizotomy (SDR) and orthopedic surgery using multidimensional (National Center for Medical Rehabilitation Research disablement framework) outcome measures. DESIGN: Prospective outcome study. SETTING: Pediatric orthopedic hospital. PARTICIPANTS: Twenty-five children with spastic diplegia. Eighteen participants (mean age, 71.3 mo) chose SDR. Seven participants (mean age, 78.6 mo) chose orthopedic surgery. INTERVENTIONS: Children were evaluated 2 days before surgical intervention and at 6 months, 1 year, and 2 years postsurgically. MAIN OUTCOME MEASURES: The Gross Motor Performance Measure, the Gross Motor Function Measure, and the Pediatric Evaluation of Disability Inventory. RESULTS: The SDR group improved significantly in quality of movement attributes 6 months postsurgically; however, gross motor skills (standing; walking, running, and jumping) gains were seen 2 years postsurgically. The orthopedic group improved significantly in select quality of movement attributes 6 months postsurgically and in standing skills within the first postsurgical year. Self-care skills, mobility, and social function gains were seen earlier and with greater frequency in the SDR group. CONCLUSIONS: Both surgical interventions demonstrated multidimensional benefits for ambulatory children with spastic diplegia. The results suggest that qualitative changes in movement, achieved by spasticity reduction, have a greater effect on the enhancement of functional skill proficiency, thus independence, than recognized.
%0 Journal Article
%1 Buckon2004a
%A Buckon, Cathleen E
%A Thomas, Susan Sienko
%A Piatt, Joseph H
%A Aiona, Michael D
%A Sussman, Michael D
%D 2004
%J Arch Phys Med Rehabil
%K Cerebral Palsy; Child; Child, Preschool; Disability Evaluation; Female; Humans; Male; Motor Activity; Orthopedic Procedures; Outcome and Process Assessment (Health Care); Prospective Studies; Rhizotomy; Spinal Nerve Roots
%N 3
%P 457--465
%T Selective dorsal rhizotomy versus orthopedic surgery: a multidimensional assessment of outcome efficacy.
%V 85
%X OBJECTIVE: To compare the efficacy of selective dorsal rhizotomy (SDR) and orthopedic surgery using multidimensional (National Center for Medical Rehabilitation Research disablement framework) outcome measures. DESIGN: Prospective outcome study. SETTING: Pediatric orthopedic hospital. PARTICIPANTS: Twenty-five children with spastic diplegia. Eighteen participants (mean age, 71.3 mo) chose SDR. Seven participants (mean age, 78.6 mo) chose orthopedic surgery. INTERVENTIONS: Children were evaluated 2 days before surgical intervention and at 6 months, 1 year, and 2 years postsurgically. MAIN OUTCOME MEASURES: The Gross Motor Performance Measure, the Gross Motor Function Measure, and the Pediatric Evaluation of Disability Inventory. RESULTS: The SDR group improved significantly in quality of movement attributes 6 months postsurgically; however, gross motor skills (standing; walking, running, and jumping) gains were seen 2 years postsurgically. The orthopedic group improved significantly in select quality of movement attributes 6 months postsurgically and in standing skills within the first postsurgical year. Self-care skills, mobility, and social function gains were seen earlier and with greater frequency in the SDR group. CONCLUSIONS: Both surgical interventions demonstrated multidimensional benefits for ambulatory children with spastic diplegia. The results suggest that qualitative changes in movement, achieved by spasticity reduction, have a greater effect on the enhancement of functional skill proficiency, thus independence, than recognized.
@article{Buckon2004a,
abstract = {OBJECTIVE: To compare the efficacy of selective dorsal rhizotomy (SDR) and orthopedic surgery using multidimensional (National Center for Medical Rehabilitation Research disablement framework) outcome measures. DESIGN: Prospective outcome study. SETTING: Pediatric orthopedic hospital. PARTICIPANTS: Twenty-five children with spastic diplegia. Eighteen participants (mean age, 71.3 mo) chose SDR. Seven participants (mean age, 78.6 mo) chose orthopedic surgery. INTERVENTIONS: Children were evaluated 2 days before surgical intervention and at 6 months, 1 year, and 2 years postsurgically. MAIN OUTCOME MEASURES: The Gross Motor Performance Measure, the Gross Motor Function Measure, and the Pediatric Evaluation of Disability Inventory. RESULTS: The SDR group improved significantly in quality of movement attributes 6 months postsurgically; however, gross motor skills (standing; walking, running, and jumping) gains were seen 2 years postsurgically. The orthopedic group improved significantly in select quality of movement attributes 6 months postsurgically and in standing skills within the first postsurgical year. Self-care skills, mobility, and social function gains were seen earlier and with greater frequency in the SDR group. CONCLUSIONS: Both surgical interventions demonstrated multidimensional benefits for ambulatory children with spastic diplegia. The results suggest that qualitative changes in movement, achieved by spasticity reduction, have a greater effect on the enhancement of functional skill proficiency, thus independence, than recognized.},
added-at = {2014-07-19T19:12:49.000+0200},
author = {Buckon, Cathleen E and Thomas, Susan Sienko and Piatt, Joseph H and Aiona, Michael D and Sussman, Michael D},
biburl = {https://www.bibsonomy.org/bibtex/26581c53f4f2b741071c1cfaf416d1bc6/ar0berts},
groups = {public},
interhash = {5985c568740dc92bc288e5dc988f0cec},
intrahash = {6581c53f4f2b741071c1cfaf416d1bc6},
journal = {Arch Phys Med Rehabil},
keywords = {Cerebral Palsy; Child; Child, Preschool; Disability Evaluation; Female; Humans; Male; Motor Activity; Orthopedic Procedures; Outcome and Process Assessment (Health Care); Prospective Studies; Rhizotomy; Spinal Nerve Roots},
month = Mar,
number = 3,
pages = {457--465},
pii = {S0003999303009353},
pmid = {15031833},
timestamp = {2014-07-19T19:12:49.000+0200},
title = {Selective dorsal rhizotomy versus orthopedic surgery: a multidimensional assessment of outcome efficacy.},
username = {ar0berts},
volume = 85,
year = 2004
}