The effects of spasticity-reducing surgery in the upper extremity were assessed in a prospective observational study of 30 consecutive patients with stroke ( = 13), incomplete spinal cord injury ( = 9), traumatic brain injury ( = 5), cerebral palsy ( = 2), and degenerative central nervous system disease ( = 1). Surgery, which included lengthening of tendons and release of muscles, was followed by early rehabilitation at three intensity levels depending on the patients' specific needs and conditions. At 12 months follow-up there were significant improvements in all outcome measures with the following mean values: spasticity decreased by 1.4 points (Modified Ashworth Scale, 0-5), visual analogue pain score by 1.3 points, and both Canadian Occupational Performance Measures increased (performance by 3.4 and satisfaction by 3.6), and most measures of joint position or mobility improved. Hand surgery combined with early and comprehensive rehabilitation improves function, activity and patients' satisfaction in patients with disabling spasticity with improvement lasting for at least 1 year. II.
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Effect of selective dorsal rhizotomy on neuromuscular symptoms, muscle morphology, and motor function in children with spastic cerebral palsy.
Dev Med Child Neurol
November 2024
Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium.
Aim: To investigate the effect of selective dorsal rhizotomy (SDR) on an integrated outcome set 1-year post-SDR, in a cohort of children with spastic cerebral palsy (CP).
Method: Fifteen children with bilateral spastic CP (median age 8 years 8 months [interquartile range 3 years 3 months], 11 males, four females, eight in Gross Motor Function Classification System (GMFCS) level II, seven in GMFCS level III) were measured pre- and 1-year post-SDR. Clinical scales and goniometry assessed plantar flexor spasticity, range of motion, strength, and selectivity.
Selective dorsal rhizotomy and its effect on muscle force during walking: A comprehensive study.
J Biomech
February 2024
The James R. Gage Center for Gait & Motion Analysis, Gillette Children's Specialty Healthcare, St. Paul, MN, United States of America. Electronic address:
Selective dorsal rhizotomy (SDR) is commonly used to permanently reduce spasticity in children with cerebral palsy (CP). However, studies have yielded varying results regarding muscle strength and activity after SDR. Some studies indicate weakness or no changes, while a recent study using NMSK simulations demonstrates improvements in muscle forces during walking.
View Article and Find Full Text PDFThe long-term effects of aggressive spasticity reducing treatment, including selective dorsal rhizotomy, on joint kinematic outcomes of persons with cerebral palsy.
Gait Posture
September 2023
Gillette Children's, USA; University of Minnesota, Department of Orthopedic Surgery, USA.
Background: Selective dorsal rhizotomy (SDR) creates a large and permanent reduction of spasticity for children with cerebral palsy (CP). Previous SDR outcomes studies have generally lacked appropriate control groups, had limited sample sizes, or reported short-term follow-up, limiting evidence for improvement in long-term gait function.
Research Question: Does aggressive spasticity management for individuals with CP improve long-term gait kinematics (discrete joint kinematics) compared to a control group of individuals with CP with minimal spasticity management?
Methods: This study was a secondary analysis - focused on joint-level kinematics - of a previous study evaluating the long-term outcomes of SDR.
Treatment of spasticity in children and adolescents with cerebral palsy in Northern Europe: a CP-North registry study.
BMC Neurol
July 2021
Department of Clinical Sciences Lund, Orthopedics, Lund University, Skåne University Hospital, 221 85, Lund, Sweden.
Background: Spasticity is present in more than 80% of the population with cerebral palsy (CP). The aim of this study was to describe and compare the use of three spasticity reducing methods; Botulinum toxin-A therapy (BTX-A), Selective dorsal rhizotomy (SDR) and Intrathecal baclofen therapy (ITB) among children and adolescents with CP in six northern European countries.
Methods: This registry-based study included population-based data in children and adolescents with CP born 2002 to 2017 and recorded in the follow-up programs for CP in Sweden, Norway, Denmark, Iceland and Scotland, and a defined cohort in Finland.
Functional outcomes of spasticity-reducing surgery and rehabilitation at 1-year follow-up in 30 patients.
J Hand Surg Eur Vol
October 2020
Centre for Advanced Reconstruction of Extremities, University of Gothenburg, Gothenburg, Sweden.
The effects of spasticity-reducing surgery in the upper extremity were assessed in a prospective observational study of 30 consecutive patients with stroke ( = 13), incomplete spinal cord injury ( = 9), traumatic brain injury ( = 5), cerebral palsy ( = 2), and degenerative central nervous system disease ( = 1). Surgery, which included lengthening of tendons and release of muscles, was followed by early rehabilitation at three intensity levels depending on the patients' specific needs and conditions. At 12 months follow-up there were significant improvements in all outcome measures with the following mean values: spasticity decreased by 1.
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