| Autor: |
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 |
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| Zdroj: |
Developmental Medicine & Child Neurology; May2022, Vol. 64 Issue 5, p561-568, 8p |
| Abstrakt: |
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 <3, by design). Interpretation: Untreated spasticity does not cause meaningful impairments in young adulthood at the level of pathophysiology, function, or quality of life. This original article is commented by Chambers on page 532 of this issue. [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
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