Assessment of motor function score according to the GMFM-88 in children with cerebral palsy after postoperative rehabilitation

Authors

  • Azra Delalić Department of Physical Medicine and Rehabilitation,University Clinical Centre Tuzla
  • Suada Kapidžić-Duraković Department of Physical Medicine and Rehabilitation,University Clinical Centre Tuzla
  • Husref Tahirović Department for Research and Education University Clinical Centre Tuzla, Tuzla

Keywords:

Cerebral palsy, Operation, Motor function

Abstract

Objective. To determine the outcome of rehabilitationtreatment after orthopedic-surgical treatment of the lowerextremities in relation to motor function and degree of disabilityin children with cerebral palsy. Subjects and methods.An historical-prospective study included 44 treated childrenwith CP from May 2000 until June 2009 at the Departmentof Physical Medicine and Rehabilitation University ClinicalCentre Tuzla. The main criteria for entering the study werediagnosed CP and performed orthopedic-surgery of the lowerextremities during rehabilitation treatment. Assessmentof the motor function score was performed according to theGross Motor Function Measure 88 (GMFM-88), and classificationof the degree of disability was developed based on thescale of the Gross Motor Function Classification System (GMFCS).Results. In our study, motor functions were improved,so that the median value and interquartil range (IQR) of thetotal GMFM score before surgery was 35.7 (IQR from 22.9 to57.2), and after postoperative rehabilitation 58.6 (IQR from31.2 to 85.2) with a high statistical significance (p<0.0001).Median value GMFCS scores before surgery ranged around5 (IQR from 4 to 5), and after postoperative rehabilitationranged around 3 (IQR from 2 to 5), which shows a highlystatistically significant reduction in the degree of disability(p<0.001). Conclusion. Surgical intervention performed onthe lower extremities in children with cerebral palsy may improvemotor function in all developmental stages and reducethe degree of disability with intensive rehabilitation.

Downloads

Download data is not yet available.

Author Biographies

Azra Delalić, Department of Physical Medicine and Rehabilitation,University Clinical Centre Tuzla

Suada Kapidžić-Duraković, Department of Physical Medicine and Rehabilitation,University Clinical Centre Tuzla

Husref Tahirović, Department for Research and Education University Clinical Centre Tuzla, Tuzla

References

Wilson MJ. Cerebral Palsy In: Campbell S (ed). Pediatric Neurologic Physical Therapy. Chicago: Churcill Livingstone; 1991. p. 301-46.

Lacombes P. Qui était-il? William John Little (1810-1894). La Gazette du Groupe d’Etude enOrthopédie Pédoatrique. 2003;10:2.

Surveillance of cerebral palsy in Europe: a collaboration of cerebral palsy surveys and registers. Dev Med & Child Neurol. 2000;42:816-24.

Infante E, De la Cruz J, Simon R, Pallas C. Neuroimaging and motor function in children with cerebral palsy. 20th Annual Meeting of the European Academy of Chidhood Disability, Neurol Croat. 2008;57(Suppl 1):38-9.

Hägglund G, Wagner Ph. Development of spasticity with age in total population of children with cerebral palsy. BMC Musculoskelet Disord. 2008;9:150.

Muñoz-Lasa S, Valero R, Jimenez M, Atin M, Varela E, Guillén M. Objective assessment of efficacy of hippotherapy in neurological diseases. In: Abstract book 5thWorld Congress of the International Society of Physical and Rehabilitation medicine; 2009 June 13-17; Istanbul, Turkey; 2009. p. 131.

Çubukçu D, Űnalp A. Managing spasticity in pediatric diplegic cerebral palsy using botulinum toxin A: A retrospective analysis. In: Abstract book 5thWorld Congress of the International Society of Physical and Rehabilitation medicine; 2009 June 13-17; Istanbul, Turkey; 2009. p. 658.

Langerak NG, Lamberts RP, Fieggen AG, Peter JC, Van Der Merwe L, Peacock WJ et al. A prospective gait analysis study in patients with diplegic cerebral palsy 20 years after selective dorsal rhizotomy. J Neurosurg Pediatr. 2008;1(3):180-86.

Truscelli D, Auféril H, Barbot F, Métayer M, Leroy-Malherbe V, Mazaeau M at al. Les infirmités motrices cérébrales. Paris: Elsevier Masson; 2008.

Gough M, Schneider P, Shortland AP.The outcome of surgical intervention for early deformity in young ambulant children with bilateral spastic cerebral palsy. Journal of Bone and Joint Surgery-Britsh. 2008;90-B(7):946-51.

Mitsiokapa EA, Mavrogenis AF, Skouteli H, Vrettos SG, Tzanos G, Kanellopoulos AD. Selective percutaneous myofascial lengthening of the lower extremities in children with spastic cerebral palsy. In: Proceedings of the 16thEuropen congess of

physical and rehabilitation medicine; 2008 June 3-6; Brugge, Belgium; 2008. p. 218-20.

Zergollern J, Marčić A, Stojčević-Polovina M, Hohnjec V. Ortopedsko-kirurško liječenje u kompleksnom rehabilitacijskom tretmanu djece s cerebralnom paralizom. An Klin Bol “Dr M. Stojanović”. 1981;23:215-20.

Borton DC, Walker K, Pirpiris M, Nattrass GR, Graham HK. Isolated calf lengthening in cerebral palsy: Outcome analysis of risk factors. J Bone Joint Surg. 2001;83-B:364-70.

Mathur N, Jain Sh, Patni A. Management of spastic diplegia in cerebral palsy. Abstract book 5thWorld Congress of the International Society of Physical and Rehabilitation medicine; 2009 June 13-17; Istanbul, Turkey; 2009. p. 18.

Russell DJ, Rosenbaum PL, Cadman DT, Gowland C, Hardy S, Jarvis S. The Gross Motor Function Measure: a means to evaluate the effects of physical therapy. Develop Med & Child Neurol. 1989;31(3):341-52.

Palisano R, Rosenbaum P, Walter S, Russell D, Wood E, Galuppi B. Development and reliability of a system to classify gross motor function in children with cerebral palsy. Dev Med & Child Neurol. 1997;39(4):214-23.

Buchan IE. Arcus QuickStat Biomedical version. 1st Ed. Cambridge: Adisson Wesley Longman Ltd; 1997.

Yang TF, Chan RC, Chuang TY, Liu TJ, Chiu JW.Treatment of cerebral palsy with botulinum toxin: evaluation with gross motor function measure. J Formos Med Assoc. 1999;98(12):832-36.

Trahan J,Malouin F. Changes in the Gross Motor Function Measure in children with diferant types of cerbral palsy: an eight-month folow-up study. Ped Phys Ther. 1999;11:12-17.

Nieuwenhuijsen CH, Van der Slot W, Beelen A, Arendzen H, Roebroeck M, Stam H, Van den Bergemons R. Inactive lifestyle in adults with bilateral spastic cerebral palsy. J Rehabil Med. 2009;41:375-81.

Saraph V, Zwick EB, Zwick G, Steinwender C, Steinwender G, Linhart W. Multilevel surgery in spastic diplegia: evaluation by physical examination and gait analysis in 25 children. J Pediatr Orthop. 2002;22(2):50-57.

Rodda JM, Graham HK, Nattrass GR, Galea MP, Baker R, Wolfe R. Correction of severe crouch gait in patients with spastic diplegia with use of multilevel orthopaedic surgery. J Bone Joint Surg Am. 2006;88(12):2653-64.

Zorer G, Doğrul C,Albayrak M, Bagatur AE. The results of single-stage multilevel muscle-tendon surgery in the lower extremities of patients with spastic cerebral palsy. Acta Orthop Traumatol Turc. 2004;38(5):317-25.

Souza DR, Collange LA, Freitas TB, Ribeiro DA, Gianni MA. Outcomes after lower limb surgery in cerebral palsy patients. In: Abstract book 5thWorld Congress of the International Society of Physical and Rehabilitation medicine; 2009 June 13-17; Istanbul, Turkey; 2009. p. 670.

Beckung E, Carlsson G, Carisdotter S, Uvebrant P. The natural history of gross motor development in children with cerebral palsy aged 1 to 15 years. Dev Med & Child Neurol. 2007;49(10):724.

Crawford H - Scoliosis progression in cerebral palsy. Journal of Bone and Joint Surgery-British. 2006; 88-B(Suppl 2):323.

Stojčević-Polovina M. Effects of intensive rehabilitation in children with cerebral palsy: our view on the neuronal group selection theory. 20th Annual Meeting of the European Academy of Chidhood Disability. Neurol Croat. 2008;57(Suppl 1):27-8.

Tsoriakis N, Evaggelinou C, Grouios G, Tsorbatzoudis C. Effect of intensive neurodevelopmental treatment in gross motor function of children with cerebral palsy. Dev Med & Child Neurol. 2004;46(11):740-45.

Tatishvili N, Gabunia M, Kakushadze Z, Tatishvili S. The Effectiveness of Early Therapeutic Intervention on Functional Independence of Children with Cerebral Palsy Int. J Ch Neuropsychiatry. 2004;1(1):21-8.

Gannotti ME, Gorton GE, Nahorniak MT, Gagnaire N, Fil A, Hogue J at al. Changes in gait velocity, mean knee flexion in stance,body mass index and popliteal angle with age in ambulatory children with cerebral palsy. J Pediatr Orthop. 2008;28 (1):103-11.

Gannoti ME, Gorton GE, Nahorniak MT, Masso PD, Lamdry B, Lyman J at al. Postoperative gait velocity and mean knee flexion in stance of ambulatory children with spastic diplegia four years or more after multilevel surgery. J Pediatr Orthop.

;27(4):451-56.

Turker RJ, Lee R. Adductor tenotomies in children with quadriplegic cerebral palsy: longer term follow-up. J Pediatr Orthop. 2000;20(3):370-74.

Zwick EB, Saraph V, Linhart WE, Steinwender G. Propulsive function during gait in diplegic children: evaluation after surgery for gait improvement. J Pediatr Orthop. 2001;B10(3):226-33.

Downloads

Published

2010-05-10

How to Cite

Delalić, A., Kapidžić-Duraković, S., & Tahirović, H. (2010). Assessment of motor function score according to the GMFM-88 in children with cerebral palsy after postoperative rehabilitation. Acta Medica Academica, 39(1), 21–29. Retrieved from https://www.ama.ba/index.php/ama/article/view/72

Issue

Section

Clinical Science

Most read articles by the same author(s)

1 2 3 4 > >> 

Similar Articles

You may also start an advanced similarity search for this article.