Bodenreaktionskräfte bei Kindern mit Cerebralparese vor und nach selektiver dorsaler Rhizotomie

Background: Cerebral palsy (CP) results from an infant brain damage and displays one of the most common reasons for physical impairment in children. It is therefore of major importance for the daily mobility and overall quality of life of these children, to continuously optimize current treatment options that improve motor function. Selective dorsal rhizotomy (SDR) is an invasive neurosurgical approach aiming to reduce spasticity of the lower extremities through the selective sectioning of afferent sensory spinal nerve rootlets. In order to detect gait pathologies and validate therapeutic outcomes, instrumented gait analysis has been proven to be a renowned tool. However, the influence of SDR on ground reaction forces (GRF), examining force curves over time during forward movement, has not been evaluated in CP children yet. Patients and methods: Within prospective 3D gait analysis force platform data of 24 ambulatory children with bilateral spastic CP (15 female, 9 male; mean age at SDR 6.4 ± 1.4 years, GMFCS Level I-III) were collected preoperatively and 12 months post SDR. Analysis of data was performed retrospectively. Besides, we assessed an age-matched lab standard of 11 typically developing children (TDC; 6 female, 5 male; mean age 6.4 ± 1.8 years). Results: CP children showed significant changes in GRF parameters 12 months post SDR. The first peak of the vertical GRF (Fz1) occurred significantly later in % stance phase post SDR (p=0.027). In the anterior-posterior (a.p.) direction, the decelerating (p=0.007) and accelerating (p=0.049) peak forces as well as the decelerating impulse (p=0.001) increased, comparing pre- to postoperative values. The a.p. net impulse decreased towards zero (p=0.034) post SDR. In addition, the postoperative results of the CP children tended to approach the results of TDC. Conclusion: In conclusion, this study shows a positive influence of SDR on several vertical and a.p. GRF parameters in CP children 12 months post SDR. These changes indicate improvements in gait stability and control as well as a more efficient forward movement.

Author dc:creator

• Zeiner, Kim Nikola

• cerebral palsy
• selective dorsal rhizotomy
• gait analysis
• ground reaction forces

Licence dc:rights.uri

• http://www.fu-berlin.de/sites/refubium/rechtliches/Nutzungsbedingungen

Language dc:language

ger

Identifier URI

http://dx.doi.org/10.17169/refubium-27630

OAI record oai:identifier

https://refubium.fu-berlin.de/oai/request?verb=GetRecord&metadataPrefix=dim&identifier=oai%3Arefubium.fu-berlin.de%3Afub188%2F27877