Influence of the percutaneous myofasciotomy on gait of children with spastic cerebral palsy - A short term, retrospective controlled analysis.

Autor: Zimmermann R; School of Medicine, Social Pediatrics, Technical University of Munich, Munich, Germany; kbo-Kinderzentrum München, Munich, Germany. Electronic address: regina.zimmermann@kbo.de., Poschmann M; Schön Klinik München Harlaching, Munich, Germany., Altschuck N; School of Medicine, Social Pediatrics, Technical University of Munich, Munich, Germany; Department Health Sciences, University of Applied Sciences, Fulda, Germany; Institute for Health Services Research and Clinical Epidemiology, Department of Medicine, University of Marburg, Germany., Bauer C; kbo-Kinderzentrum München, Munich, Germany., von Pfeil D; kbo-Kinderzentrum München, Munich, Germany., Bernius P; Schön Klinik München Harlaching, Munich, Germany., Mall V; School of Medicine, Social Pediatrics, Technical University of Munich, Munich, Germany; kbo-Kinderzentrum München, Munich, Germany., Jung NH; School of Medicine, Social Pediatrics, Technical University of Munich, Munich, Germany; kbo-Kinderzentrum München, Munich, Germany. Electronic address: nikolai.jung@tum.de.
Jazyk: angličtina
Zdroj: Gait & posture [Gait Posture] 2023 Jul; Vol. 104, pp. 159-164. Date of Electronic Publication: 2023 Jun 30.
DOI: 10.1016/j.gaitpost.2023.06.023
Abstrakt: Background: One of the primary causes in children with cerebral palsy (CP) leading to gait disorders is an increased muscle tone which may secondary result in a shortening of the muscle fascia. Percutaneous myofasciotomy (pMF) is a minimal-invasive surgical intervention correcting the shortened muscle fascia and aims to extend the range of motion.
Research Question: What is the effect of pMF on gait in children with CP three months and one year post-OP?
Methods: Thirty-seven children (f: n = 17, m: n = 20; age: 9,1 ± 3,9 years) with spastic CP (GMFCS: I-III, bilateral (BSCP): n = 24, unilateral (USCP): n = 13) were retrospectively included. All children underwent a three dimensional gait analysis with the Plug-in-Gait-Model before (T0) and three months after pMF (T1). Twenty-eight children (bilateral: n = 19, unilateral: n = 9) underwent a one-year follow-up-measurement (T2). Differences in the Gait Profile Score (GPS), kinematic gait data, gait-related functions and mobility in daily living were statistically analyzed. Results were compared to a control group (CG) matched in age (9,5 ± 3,5 years), diagnosis (BSCP: n = 17; USCP: n = 8) and GMFCS-level (GMFCS I-III). This group was not treated with pMF but underwent two gait analyses in twelve months.
Results: The GPS improved significantly in BSCP-pMF (16,46 ± 3,71° to 13,37 ± 3,19°; p < .0001) and USCP-pMF (13,24 ± 3,27° to 10,16 ± 2,06°; p = .003) from T0 to T1 with no significant difference between T1 and T2 in both groups. In CG there was no difference in the GPS between the two analyses.
Significance: PMF may in some children with spastic CP improve gait function three months as well as for one-year post-OP. Medium and long-term effects, however, remain unknown and further studies are needed.
Competing Interests: Declaration of Competing Interest The other authors have no conflicts of interest to declare.
(Copyright © 2023 Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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