Quantifying Active Ankle Range of Motion in Cerebral Palsy Following Selective Dorsal Rhizotomy

Abstract

This study was conducted to determine whether an objective and quantitative measure for active ankle range of motion would be sensitive to differences between persons of able body and those with cerebral palsy (CP), and between pre- and postselective dorsal rhizotomy (SDR). Twelve children with spastic diplegia CP were tested before undergoing an SDR, and again after 8 months of intensive physical therapy (SDR group). Fourteen other children with spastic diplegia were tested initially and again 8 months following no intervention but maintaining their existing level of physical therapy (CP group). Twenty age-matched children of able body were tested once (AB group). A video system recorded active sagittal plane ankle movements as the seated child independently performed maximum dorsiflexion and plantarflexion. The data were tracked and analyzed to determine end-range dorsiflexion and plantarflexion, and total active ankle range of motion. Repeated-measures ANOVA and Tukey post hoc tests were used to test for significant differences among and between groups,p< 0. 05. Results for the SDR group indicated a significant increase in end-range dorsiflexion and total range of motion following the surgery, with no changes in any measures for the CP group. Results for both groups with CP indicated differences vs. the AB group. The measure provided additional information from what has previously been reported for active ankle range of motion. The integration of this measure with other objective measures for quantifying impairments and presurgical function may be useful in predicting post-SDR gait status and other functional activities.