Effects of Selective Posterior Rhizotomy on Motor Control and Gait in Children with Cerebral Palsy

選擇性背神經根切除術對腦性麻痺患者運動控制及步態之影響

黃美涓(Alice May-Kuen Wong) ； 陳嘉玲(Chia-Ling Chen) ； 雷大雅(Tai-Ngar Lui) ； 鄧復旦(Fuk-Tan Tang) ； 洪維憲(Wei-Hsien Hong) ； 周適偉(Shih-Wei Chou)

《中華民國復健醫學會雜誌》 27卷3期 (1999/09) Pp. 103-115

摘要

This study evaluates how selective posterior rhizotomy (SPR) affects the motor control pattern of children diagnosed with cerebral palsy (CP) by using polyelectromyography and gait performance. Twenty-four spastic children diagnosed with CP aged 3 to 16 years old were included in this study. Another twenty children diagnosed with CP who had only undergone rehabilitation were selected as the control group. The children diagnosed with CP received polyelectromyography and gait analysis within one month before treatment (SPR or only rehabilitation) and 9 months to 1 year after treatment. Gait analysis included gait patterns and kinematic parameters. The gait pattems were scored by the shapes of their gaitline and cyclogram. The motor control patterma were scored by their temporal and spatial features using polyelectromyography. The cerebral palsy patients were divided into independent, dependent, and non-ambulators groups. Motor control and gait patterns significantly improved after SPR than when only rehabilitation was performed; positive changes were also observed in kinematic parameters before and after SPR. In addition, although motor control after surgery significantly improved in the independent and dependent ambulator groups (P＜0.01), the non-ambulator group did not. Closely examining the changes in their gaitlines and cyclograms revealed that the independent and dependent ambulators significantly improved as well. Results in this study suggested that motor control and gait patterns improved after SPR at around 1 year among the independent and dependent ambulators groups. However, these progressions were insignificant in the non-ambulators group.

關鍵字

腦性麻痺 ； 選擇性背神經根切除術 ； 運動控制 ； 步態分析

並列摘要

This study evaluates how selective posterior rhizotomy (SPR) affects the motor control pattern of children diagnosed with cerebral palsy (CP) by using polyelectromyography and gait performance. Twenty-four spastic children diagnosed with CP aged 3 to 16 years old were included in this study. Another twenty children diagnosed with CP who had only undergone rehabilitation were selected as the control group. The children diagnosed with CP received polyelectromyography and gait analysis within one month before treatment (SPR or only rehabilitation) and 9 months to 1 year after treatment. Gait analysis included gait patterns and kinematic parameters. The gait pattems were scored by the shapes of their gaitline and cyclogram. The motor control patterma were scored by their temporal and spatial features using polyelectromyography. The cerebral palsy patients were divided into independent, dependent, and non-ambulators groups. Motor control and gait patterns significantly improved after SPR than when only rehabilitation was performed; positive changes were also observed in kinematic parameters before and after SPR. In addition, although motor control after surgery significantly improved in the independent and dependent ambulator groups (P＜0.01), the non-ambulator group did not. Closely examining the changes in their gaitlines and cyclograms revealed that the independent and dependent ambulators significantly improved as well. Results in this study suggested that motor control and gait patterns improved after SPR at around 1 year among the independent and dependent ambulators groups. However, these progressions were insignificant in the non-ambulators group.

並列關鍵字

Cerebral palsy ； selective posterior rhizotomy ； motor control ； gait analysis