100 Functional mobility in ambulatory children with bilateral spastic cerebral palsy at two years following single-level selective dorsal rhizotomy

Abstract

<h3>Introduction</h3> The primary goal of selective dorsal rhizotomy (SDR) is improvement in functional mobility. Outcomes at 2 years after single-level SDR and rehabilitation are presented for ambulatory children (Gross Motor Classification System (GMFCS) levels II and III) with bilateral spastic cerebral palsy. <h3>Method</h3> Data from 82 children, GMFCS level II (n=26) and III (n=56) who underwent SDR and 2 years follow-up were analysed. Mean age (SD; range) at SDR surgery was 6yrs 7m (2yrs 2m; 2yrs 9m to 13yrs 8m). Functional mobility outcomes were the 6-minute walk test (6MWT) and two parent-reported measures, the Functional Mobility Scale (FMS) and the Gillette Functional Assessment Questionnaire (FAQ). <h3>Results</h3> 6MWT distance, mean (95% CI), improved by 119.8m (86.1 to 153.4m, p&lt; 0.001) in GMFCS level II, and by 49.6m (17.7 to 81.6m, p=0.003) in GMFCS level III. Ratings on the 1–6 FMS-5m, 50m, 500m improved by at least 1 in 46.2%, 73.1% and 59.3% (p£ 0.008) in GMFCS level II and 56.1%, 53.4% and 35.1% (p£ 0.005) in GMFCS level III. Ratings on the 1–10 FAQ improved by at least 1 in 52% (n=25, p=0.004) and 55.6% (n=45, p=0.015) of children in GMFCS level II and III respectively. Deterioration in all scores was observed in 2/82 children. <h3>Conclusion</h3> Data show significant improvements in functional mobility in the majority of children in both GMFCS level II and III at 2 years after SDR. Further study is required to identify how these changes impact habitual physical activity in daily life.