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Evolution of self‐care and functional mobility after single‐event multilevel surgery in children and adolescents with spastic diplegic cerebral palsy
Author(s) -
Dequeker Griet,
Van Campenhout Anja,
Feys Hilde,
Molenaers Guy
Publication year - 2018
Publication title -
developmental medicine and child neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.658
H-Index - 143
eISSN - 1469-8749
pISSN - 0012-1622
DOI - 10.1111/dmcn.13683
Subject(s) - cerebral palsy , medicine , activities of daily living , spastic , physical therapy , gross motor function classification system , psychological intervention , spastic diplegia , nursing
Aim To explore the evolution of self‐care and functional mobility after multilevel surgery in children and adolescents with spastic diplegic cerebral palsy and to identify factors affecting these outcomes. Method Thirty‐four participants (22 males, 12 females) were evaluated before surgery, and at 2 months, 6 months, 1 year, 18 months, and 2 years after surgery. Self‐care was assessed with the Pediatric Evaluation of Disability Inventory Dutch edition. The Mobility Questionnaire47 (MobQues47) and Functional Mobility Scale (FMS) were used to measure functional mobility. Results All outcomes revealed a significant decrease 2 months after single‐event multilevel surgery (SEMLS) ( p ‐value between <0.001 and 0.02) followed by a significant increase at 6 months ( p <0.001 and p =0.045). Between 6 months and 1 year, a significant increase was also revealed for Mobques47 ( p <0.001), FMS ( p ≤0.008), and the Pediatric Evaluation of Disability Inventory Functional Skills Scale (PEDI‐FSS) ( p =0.001). Improvement continued until 18 months for the PEDI‐FSS. Initial score, initial muscle strength, Gross Motor Function Classification System level, age, and number of surgical interventions significantly influenced time trends for self‐care and/or functional mobility. Interpretation Most preoperative scores are regained at 6 months after SEMLS. Further improvement is seen until 18 months. Participants with a higher functional level before surgery will temporarily lose more than participants with lower initial functional ability, but they also fast regain their function. What this paper adds Self‐care and functional mobility decrease significantly in the first months after single‐event multilevel surgery (SEMLS). Six months after SEMLS most preoperative scores are regained. Impact of SEMLS is more pronounced for functional mobility than for self‐care. Muscle strength and functionality at baseline are important influencing factors on the evolution after SEMLS.