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J Korean Acad Rehabil Med. 1997 Apr;21(2):399-405. Korean. Original Article.
Chun KH , Kim BO , Yune SH .
Department of Rehabilitation Medicine, College of Medicine, Chungnam National University, Korea.
Abstract

Selective posterior rhizotomy (SPR) is a neurosurgical procedure designed to alleviate spasticity and has been successfully used for children with spastic cerebral palsy. We evaluated eleven children who had follow up over 6 months after SPR among sixteen children who underwent SPR from August 1995 to July 1996. The authors have analyzed the status of the children with spastic cerebral palsy before and after operation to determine the effects of this therapy on muscle tone, functional grade, gross motor function and gait pattern. Gross motor function was measured by gross motor function measure(GMFM) scale. Postoperative tests showed reduction in muscle tone in all cases compared with preoperative assessments. Functional grade was increased in 90% of the cases more than one grade. The total gross motor mean score change between the preoperative and 6 months postoperative score was 16. Gross motor scores were analysed in each of 5 dimensions(88 conditions), i.e., lying and rolling, sitting, crawling and kneeling, standing, and walking, running, jumping. Gross motor score for each dimension improved in all cases. The greatest improvement was seen in sitting scores. The results of gait analysis of 2 ambulatory patients showed increased range of motion of hip and knee joints throughout the gait cycle and increased ankle dorsiflexion during swing phase. These results showed that SPR combined with intensive postoperative rehabilitation for children with spastic cerebral palsy had a significant positive effect on gross motor function.

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