Effect of Designed Physical Training After Selective Dorsal Rhizotomy on Motor Function of Ambulant Children With Spastic Diplegia

Cairo University42 enrolled

Overview

The management of cerebral palsy is complex and requires a multidisciplinary approach. Selective dorsal rhizotomy is a neurosurgical technique that aims to reduce spasticity in the lower limbs and improve motor function.

the current study is designed to assess the effectiveness of Selective dorsal rhizotomy on motor function in ambulant children with spastic diplegia. therefore, A convenient sample of ambulant children with spastic diplegia will be allocated to two groups of equal numbers (control and experimental)

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

TRIPLE

Enrollment

Conditions

Cerebral Palsy

Interventions

Concomitant physical rehabilitationOTHER

Children of this group will receive a regular exercise rehabilitation program including starching exercises, functional strength training and static and dynamic balance exercises.The program will be conducted by six licensed pediatric physical therapists for one hour/session, 3 times/week, and six successive months.

Standard Orthotic ManagementOTHER

A custom-made articulating ankle foot orthosis was prescribed with a hinge at the level of the medial malleolus extends distally to the tip of the toes and proximally on the posterior surface of the leg to about 5 cm below the knee and secured straps. It is fabricated to permit free ankle dorsiflexion and lock the plantar flexion at 0 dorsiflexion. The splinting schedule started gradually for 2 h/day in the first month, 4 h/day in the second month to the entire wake-up time of the day.

selective dorsal rhizotomy

Eligibility

Sex: ALLMin age: 4 YearsMax age: 8 Years

Medical Language ↔ Plain English

Inclusion Criteria: * CP, spastic diplegia * 4-8 years of age * The ability to walk with or without assistive devices typically on Level II-III on Gross Motor Function Classification System * At least six months after the last Botulinum toxin A injection in the lower extremities * Average intelligent quotient according to medical records for active participation * Good trunk control with good antigravity strength of lower extremity on clinical examination. Exclusionary criteria * Ankle clonus; exaggerated deep tendon reflex in the legs * Babinski sign * Structural non-reducible deformities or musculoskeletal surgery in the lower extremities in the past 12 months * Moderate to severe signs of dystonia, athetosis or ataxia.

Locations (1)

Amira Mahmoud Abd-elmonem

Giza, Egypt

Outcomes

Primary Outcomes

Functional Balance

The pediatric balance scale was used to assess the child's functional performance with total score is 56 and higher score representing a better performance.