Τίτλος:
Improving gait and lower-limb muscle strength in children with cerebral palsy following Selective Percutaneous Myofascial Lengthening and functional physiotherapy
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Background: Selective Percutaneous Myofascial Lengthening (SPML) is an innovative minimally invasive surgical procedure, using micro incisions often combined with alcohol nerve block, for managing muscle contractures and stiffness in children with cerebral palsy (CP). There is lack of evidence of effects of a combined intervention of SPML and physiotherapy on gait function and muscle strength in CP. Objective: This study investigated the change in gait function and muscle strength in children with CP who underwent gait laboratory assessment before and after SPML, combined with obturator nerve blocks, and 9-month post-surgical functional physiotherapy. Methods: Ten children with bilateral spastic CP, Gross Motor Function Classification System (GMFCS) level II-IV, age 5-7 years, participated in this study. The Global Gait Graph Deviation Index (Global GGDI) and isometric muscle strength (hand-held dynamometry) were the primary outcome measures. Changes in spatiotemporal gait parameters, gross motor function and GMFCS level were secondarily examined. Results: A significant improvement of Global GGDI was found (p<0.05). The mean strength in hip flexors, extensors and adductors, knee extensors, and ankle dorsiflexors increased significantly (p<0.05). Children improved significantly their GMFCS level and gross motor capacity (p<0.05). Conclusions: SPML procedure combined with functional physiotherapy can improve gait function and lower-limb muscle strength. © 2018 IOS Press and the authors. All rights reserved.
Συγγραφείς:
Skoutelis, V.C.
Kanellopoulos, A.
Vrettos, S.
Gkrimas, G.
Kontogeorgakos, V.
Περιοδικό:
Neurorehabilitation
Λέξεις-κλειδιά:
adductor magnus muscle; ankle; Article; assessment of humans; cerebral palsy; child; clinical article; dynamometry; extensor muscle; female; flexor muscle; functional status; gait; Global Gait Graph Deviation Index; Gross Motor Function Classification System; hip muscle; human; incision; knee; laboratory test; leg muscle; male; minimally invasive surgery; motor performance; muscle contracture; muscle isometric contraction; muscle strength; nerve block; obturator nerve; outcome assessment; physiotherapy; postoperative period; preschool child; range of motion; resistance training; school child; selective percutaneous myofascial lengthening; spasticity; treatment outcome; adolescent; cerebral palsy; leg lengthening; lower limb; muscle strength; neurorehabilitation; pathophysiology; procedures, Adolescent; Bone Lengthening; Cerebral Palsy; Child; Female; Gait; Humans; Lower Extremity; Male; Muscle Strength; Neurological Rehabilitation; Physical Therapy Modalities
