Skoutelis V1, Kanellopoulos A2, Vrettos S3, Kontogeorgakos V1,4
1National and Kapodistrian University of Athens, Medical School, Athens, Greece, 2‘Iaso’ Children’s Hospital, Orthopaedic Centre, Marousi, Greece, 3‘E-N-A’ Pediatric Physiotherapy Centre, Chalandri, Greece, 4‘Attikon’ General University Hospital, First Department of Orthopaedics, Chaidari, Greece
Background: Even though cerebral palsy (CP) is a static encephalopathy, the secondary musculotendinous contractures are progressive. The development of fixed contractures, between the age of 5 to 8 ages, has negative impact on skeletal alignment -raising much severer musculoskeletal pathology- gross motor function and on quality of life. Surgery for correction of fixed contractures has been shown to improve functioning and quality of life. Selective percutaneous myofascial lengthening (SPML) is a new, minimally invasive surgical method, often combined with alcohol nerve blocks, which is used alternatively to traditional open surgical lengthening. However, there is little evidence supporting better health-related quality of life for children with CP after SPML procedure. Besides, there is no study examining the effects of a comprehensive programme of SPML procedure and specific post-surgical physiotherapy protocol, based on functional (strength) training.
Purpose: To evaluate the health-related quality of life following SPML procedure and functional physiotherapy in school-aged children with spastic CP, aged between 5-7 years.
Methods: A before-and-after trial without control study design was used. Ten children (5 males, 5 females) with spastic uni- and bilateral CP (mean age 6.2±0,79 years) and GMFCS levels II-IV, underwent SPML surgical procedure and functional physiotherapy for a period of 9 months. The proxy version of DISABKIDS Smiley measure (DSM) was used for evaluating the health-related quality of life (expressed in 100-point scale), which was completed by the children's parents. Dependent t-tests were conducted to compare pre- and post-treatment scores in the DSM, using SPSS statistical software (version 21.0, IBM-SPSS Inc., Chicago, IL). P-values less than 0.05 were regarded as significant.
Results: After 9-month of intervention the children with CP showed significantly higher quality of life scores (mean pre-post difference=13.35±12.70, p=0.009) in the DSM.
Conclusion(s): This study demonstrated that the children with CP presented better health-related quality of life after a comprehensive programme of SPML procedure and functional physiotherapy. Further research with larger number of children will verify these findings.
Implications: These results illustrated the beneficial effect of the SPML procedure and post-surgical functional physiotherapy on the general quality of life and the level of distress in children with CP. The children appeared to gain better psychosomatic functioning and well-being, which are critical aspects of participation in life situations.
Keywords: Cerebral palsy, Physiotherapy, Health-related quality of life
Funding acknowledgements: This study was self-funded.
Purpose: To evaluate the health-related quality of life following SPML procedure and functional physiotherapy in school-aged children with spastic CP, aged between 5-7 years.
Methods: A before-and-after trial without control study design was used. Ten children (5 males, 5 females) with spastic uni- and bilateral CP (mean age 6.2±0,79 years) and GMFCS levels II-IV, underwent SPML surgical procedure and functional physiotherapy for a period of 9 months. The proxy version of DISABKIDS Smiley measure (DSM) was used for evaluating the health-related quality of life (expressed in 100-point scale), which was completed by the children's parents. Dependent t-tests were conducted to compare pre- and post-treatment scores in the DSM, using SPSS statistical software (version 21.0, IBM-SPSS Inc., Chicago, IL). P-values less than 0.05 were regarded as significant.
Results: After 9-month of intervention the children with CP showed significantly higher quality of life scores (mean pre-post difference=13.35±12.70, p=0.009) in the DSM.
Conclusion(s): This study demonstrated that the children with CP presented better health-related quality of life after a comprehensive programme of SPML procedure and functional physiotherapy. Further research with larger number of children will verify these findings.
Implications: These results illustrated the beneficial effect of the SPML procedure and post-surgical functional physiotherapy on the general quality of life and the level of distress in children with CP. The children appeared to gain better psychosomatic functioning and well-being, which are critical aspects of participation in life situations.
Keywords: Cerebral palsy, Physiotherapy, Health-related quality of life
Funding acknowledgements: This study was self-funded.
Topic: Paediatrics: cerebral palsy
Ethics approval required: Yes
Institution: ‘Attikon’ University General Hospital
Ethics committee: Scientific Council
Ethics number: ΕΒΔ 2199/14-03-2017
All authors, affiliations and abstracts have been published as submitted.
