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ISSN 2992-8036 (Electronic)
ISSN 2306-4102 (Print)
Órgano Oficial del Colegio Mexicano de Ortopedia y Traumatología

2010, Number 5

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Acta Ortop Mex 2010; 24 (5)

Neuro-motor evaluation of patients with spastic cerebral palsy treated with orthopedic surgery in the Instituto Nacional de Rehabilitación

Piana AR, Viñals CL, Del Valle MC, Arellano MS, Redón AT, Peralta SC, León SL

Language: Spanish
References: 30
Page: 331-337
PDF size: 418.30 Kb.


ABSTRACT

Background: Cerebral palsy (CP) is a static neurologic condition resulting from a brain lesion occurring before the completion of brain development. The goal of management is not cure, but increasing patients’ functionality and improving their capabilities and maintaining their locomotion, cognitive development, social interaction and independence. The best results are obtained with an early and intensive management that includes physical and occupational therapy, medical and surgical treatments, mechanical aids and the management of concomitant conditions. Objective: To assess the neuromotor improvement in patients with spastic CP after surgical treatment at the National Rehabilitation Institute. Patients and methods: Patients with a diagnosis of spastic CP who presented at the Pediatric Rehabilitation outpatient service were referred to the Joint CP Clinic from January 2007 to January 2008, and underwent surgical treatment of the pelvic limbs. They were assessed 3 times and underwent neuromotor tests with gross motor function measure (GMFM), which was rated with the gross motor function classification system (GMFCS). Results: Most of the patients had improvement in the muscle tone and contracture assessments as well as in the GMFM, and their self-mobility increased one level. Conclusions: Significant improvements were seen in the muscle tone and contractures after surgery; the GMFM and the self-mobility levels in the GMFCS also improved. Multiple level surgery together with a postoperative physical therapy program results in considerable improvements in the gross motor function measure of patients with spastic CP.


REFERENCES

  1. Paneth N, Hong T, Korzeniewski S: The descriptive epidemiology of cerebral palsy. Clin Perinatol 2006; 33: 251-67.

  2. Arroyave G, Jarillo E, Garfias M, Ribera D, Uribe J: La parálisis cerebral en México. Rev Esp Salud Pública 2000; 74: 549-59.

  3. Pollock G: Surgical treatment of cerebral palsy. J Bone Joint Surgery 2001; 44: 68-81.

  4. Palisano R, Hanna S, Rosenbaum P, Russell D, Walter S, Wood E, Raina, et al: Validation of a model of gross motor function for children with cerebral palsy. Phys Ther 2000; 80: 974-85.

  5. Ketelaar M, Vermeer A, Helders P: Functional motor abilities of children with cerebral palsy: A systematic literature review of assessment measures. Clin Rehabil 2000; 12: 369-80.

  6. Wood E, Rosenbaum P: The gross motor function classification system for cerebral palsy: A study of reliability and stability over time. Dev Med Child Neurol 2000; 42: 292-6.

  7. Morris C, Bartlett D: Gross motor function classification system: Impact and utility. Dev Med Child Neurol 2004; 46: 60-5.

  8. Rosenbaum P, Walter S, Hanna S, Palisano R, Russell D, Raina P, et al: Prognosis for gross motor function in cerebral palsy. JAMA 2002; 288: 1357-63.

  9. Shapiro B: Cerebral palsy: A reconceptualization of the spectrum. J Pediatr 2004; 145: 3-7.

  10. Jarvis S, Glinianaia S, Blair E: Cerebral palsy and intrauterine growth. Clin Perinatol 2006; 33: 285-300.

  11. Palmer F: Strategies for the early diagnosis of cerebral palsy. The J Pediatr 2004; 145: 8-11.

  12. Krigger K: Cerebral palsy: An overview. Am Fam Physician 2006; 73: 91-100.

  13. Liptak G, Accardo P: Health and social outcomes of children with cerebral palsy. J Pediatr 2004; 145: 36-41.

  14. Kulak W, Sobaniec W, Smigielska J, Kubas B, Walecki J: A comparison of spastic diplegic and tetraplegic cerebral palsy. Pediatr Neurol 2005; 32: 311-7.

  15. Mewasingh L, Sekhara T, Pelc K, Missa A, Cheron G, Dan B: Motor strategies in standig up in children with hemiplegia. Pediatr Neurol 2003; 3: 257-61.

  16. Nordmark E, Hägglund G, Lagergren J: Cerebral palsy in Southern Sweden. Prevalence and clinical features. Acta Paediatr 2001; 90: 1271-6.

  17. Nordmark E, Hägglund G, Lagergren J: Cerebral palsy in Southern Sweden. Gross motor function and disabilities. Acta Paediatr 2001; 90: 1277-82.

  18. Russell D, Rosenbaum P, Lane M, Gowland C, Goldsmith C, Boyce W, at al: Training users in the gross motor function measure: Methodological and practical issues. Phys Ther 2002; 74: 630-6.

  19. Russell D, Gorter J: Assessing functional differences in gross motor skills in children with cerebral palsy who use an ambulatory aid or orthoses: Can the GMFM-88 Help? Dev Med Child Neurol 2005; 47: 462-7.

  20. Russell D, Avery L, Rosenbaum P, Raina P, Walter S, Palisano R: Improved scaling of the gross motor function measure for children with cerebral palsy: Evidence of reliability and validity. Phys Ther 2000; 80: 873-85.

  21. Vohr B, Msall M, Wilson D, Wright L, McDonald S, Pole K: Spectrum of gross motor function in extremely low birth weight children with cerebral palsy at 18 months of age. Pediatrics 2006; 116: 123-9.

  22. Golomb M, Garg B, Williams L: Measuring gross motor recovery in young children with early brain injury. Pediatr Neurol 2004; 31: 311-7.

  23. Hutton J: Cerebral palsy life expectancy. Clin Perinatol 2006; 33: 545-55.

  24. Msall M: The panorama of cerebral palsy after very and extremely preterm birth: Evidence and challenges. Clin Perinatol 2006; 33: 269-84.

  25. Ketelaar M, Vermeer A, Hart H, Beek E, Helders P: Effects of functional therapy program on motor abilities of children with cerebral palsy. Phys Ther 2001; 81: 1534-45.

  26. Fixsen J: Surgical treatment of the lower limbs in cerebral palsy: An overview. J Royal Soc Med 2000; 72: 761-5.

  27. Karol L: Surgical management of the lower extremity in ambulatory children with cerebral palsy. J Am Acad Orthop Surg 2004; 12: 196-203.

  28. Soo B, Howard J, Boyd R, Reid S, Lanigan A, Wolfe R, et al: Hip displacement in cerebral palsy. J Bone Joint Surgery 2006; 88-A: 121-9.

  29. Presedo A, Oh C, Darney K, Miller F: Soft-tissue releases to treat spastic hip subluxation in children with cerebral palsy. J Bone Joint Surgery 2005; 87-A: 832-41.

  30. Henderson-Tilton A: Approach to the rehabilitation of spasticity and neuromuscular disorders in children. Neurol Clin 2003; 21: 853-81.




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