Physician and family perception of the results of multiple orthopedic surgeries in children with cerebral palsy

Abstract

To compare the perception of physicians and families regarding the results of multilevel orthopedic surgery of the lower limbs to improve gait in children with cerebral palsy. An evaluation of medical records and pre- and postoperative videos of children attended in the walking laboratory was carried out. The outcome of the surgical treatment was evaluated by applying not only the physician rating scale, but also the Gillette functional assessment questionnaire (FAQ), as well as perception questionnaires to assess the relatives' perspective. 243 patients were evaluated. According to the functional evaluation questionnaire, 45 cases worsened, 103 improved and 95 remained stable (p<0.001). The physician rating scale showed that gait got worse in 13 cases, improved in 210 and was the same in 20. The overall perception of the treatment outcome was favorable among relatives. A weak but significant correlation between the change in the physician's average score and family satisfaction (r=0.15; p=0.016) was found, as well as between the physician's overall perception and the family's perception (r=1, 5; p=0.015). The results of the surgical treatment were favorable for both the physician and the family. Although most cases retained functional status according to the gross motor function classification system (GMFCS), a significant proportion of patients improved according to the Gillette functional assessment questionnaire (FAQ).