Self-Help and Upper Extremity Changes in 36 Children with Cerebral Palsy Subsequent to Selective Posterior Rhizotomy and Intensive Occupational and Physical Therapy

Abstract

In this descriptive study we evaluated the impact of selective posterior rhizotomy surgery and intensive physical and occupation therapy six weeks post-surgery on 36 children with cerebral palsy. The subject ranged in age form 2 to 11 years, with a median age of 4 years. They were classified according to the type of cerebral palsy (spastic diplegic or quadriplegic) and cognition (high or low). We evaluated self-help skills, upper extremity muscle tone, range of motion, and reach, grasp and release patterns the day before surgery, six weeks after surgery and one year post-surgery. Chisquare analysis failed to support statistically significant outcomes between subject groups, however gains were noted in the total group of children studies. The greatest functional gains were in lower body dressing, followed by up body dressing, and feeding. Changes in upper limb mobility patterns were minimal and failed to correlated with the gains demonstrated in the self-help domain. Children with spastic diplegia and high cognition made greater gains in self-help skills than did those who were classified as having spastic quadriplegia and low cognition.