The purpose of this study was to use three-dimensional gait analysis to describe the gait status of adults with spastic diplegia who underwent selective dorsal rhizotomy (SDR) in childhood. Outcome measures were the gait deviation index (GDI), non-dimensional temporal-distance parameters, and kinematics of the lower limbs. A total of 31 adults with spastic diplegia who had previously undergone SDR were eligible and participated in current study (SDR group). These participants had a median age of 26.8 years (range 21-44 years) with a mean time between surgery and assessment of 21.2?2.9 years (range 17-26 years). For comparison purposes, 43 typically developed adults also participated (CONTROL group), with a median age of 28.3 years (range 21-45 years). More than 17 years after SDR 58\% of the SDR group showed improved GMFCS levels, while none of them deteriorated. The participants in the SDR group walked with a mild crouch gait, although there was a loading response, adequate swing-phase knee flexion, adequate swing-phase plantarflexion, reasonable speed and cadence. The gait status of the SDR group more than 17 years after SDR was similar to what has been reported in short-term follow-up studies, as well as our earlier 20 year follow-up study that did not include 3D gait analysis. Appropriate orthopaedic intervention was required in 61\% of the study cohort. Whether the types and numbers of orthopaedic interventions are positively affected by SDR remains an open question. Further studies examining this question are warranted. In addition, long-term follow-up studies focused on other interventions would also be of clinical relevance.
MRC/UCT Medical Imaging Research Unit, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, South Africa. Nellekelangerak@hotmail.com
%0 Journal Article
%1 Langerak2012
%A Langerak, Nelleke G
%A Tam, Nicholas
%A Vaughan, Christopher L
%A Fieggen, A. Graham
%A Schwartz, Michael H
%D 2012
%J Gait Posture
%K Adolescent; Adult; Age Factors; Ankle Joint, physiopathology; Biomechanics; Case-Control Studies; Cerebral Palsy, complications/diagnosis/surgery; Disability Evaluation; Female; Follow-Up Gait Disorders, Neurologic, etiology/physiopathology; Gait, physiology; Hip Humans; Knee Male; Middle Aged; Orthopedic Procedures, methods; Patient Selection; Range of Motion, Articular, Reference Values; Rhizotomy, Risk Assessment; Severity Illness Index; Task Performance and Analysis; Time Young Adult
%N 2
%P 244--249
%R 10.1016/j.gaitpost.2011.09.014
%T Gait status 17-26 years after selective dorsal rhizotomy.
%U http://dx.doi.org/10.1016/j.gaitpost.2011.09.014
%V 35
%X The purpose of this study was to use three-dimensional gait analysis to describe the gait status of adults with spastic diplegia who underwent selective dorsal rhizotomy (SDR) in childhood. Outcome measures were the gait deviation index (GDI), non-dimensional temporal-distance parameters, and kinematics of the lower limbs. A total of 31 adults with spastic diplegia who had previously undergone SDR were eligible and participated in current study (SDR group). These participants had a median age of 26.8 years (range 21-44 years) with a mean time between surgery and assessment of 21.2?2.9 years (range 17-26 years). For comparison purposes, 43 typically developed adults also participated (CONTROL group), with a median age of 28.3 years (range 21-45 years). More than 17 years after SDR 58\% of the SDR group showed improved GMFCS levels, while none of them deteriorated. The participants in the SDR group walked with a mild crouch gait, although there was a loading response, adequate swing-phase knee flexion, adequate swing-phase plantarflexion, reasonable speed and cadence. The gait status of the SDR group more than 17 years after SDR was similar to what has been reported in short-term follow-up studies, as well as our earlier 20 year follow-up study that did not include 3D gait analysis. Appropriate orthopaedic intervention was required in 61\% of the study cohort. Whether the types and numbers of orthopaedic interventions are positively affected by SDR remains an open question. Further studies examining this question are warranted. In addition, long-term follow-up studies focused on other interventions would also be of clinical relevance.
@article{Langerak2012,
abstract = {The purpose of this study was to use three-dimensional gait analysis to describe the gait status of adults with spastic diplegia who underwent selective dorsal rhizotomy (SDR) in childhood. Outcome measures were the gait deviation index (GDI), non-dimensional temporal-distance parameters, and kinematics of the lower limbs. A total of 31 adults with spastic diplegia who had previously undergone SDR were eligible and participated in current study (SDR group). These participants had a median age of 26.8 years (range 21-44 years) with a mean time between surgery and assessment of 21.2?2.9 years (range 17-26 years). For comparison purposes, 43 typically developed adults also participated (CONTROL group), with a median age of 28.3 years (range 21-45 years). More than 17 years after SDR 58\% of the SDR group showed improved GMFCS levels, while none of them deteriorated. The participants in the SDR group walked with a mild crouch gait, although there was a loading response, adequate swing-phase knee flexion, adequate swing-phase plantarflexion, reasonable speed and cadence. The gait status of the SDR group more than 17 years after SDR was similar to what has been reported in short-term follow-up studies, as well as our earlier 20 year follow-up study that did not include 3D gait analysis. Appropriate orthopaedic intervention was required in 61\% of the study cohort. Whether the types and numbers of orthopaedic interventions are positively affected by SDR remains an open question. Further studies examining this question are warranted. In addition, long-term follow-up studies focused on other interventions would also be of clinical relevance.},
added-at = {2014-07-19T20:40:34.000+0200},
author = {Langerak, Nelleke G and Tam, Nicholas and Vaughan, Christopher L and Fieggen, A. Graham and Schwartz, Michael H},
biburl = {https://www.bibsonomy.org/bibtex/25a3c82e4a73a16eecaa86005aeb1567c/ar0berts},
doi = {10.1016/j.gaitpost.2011.09.014},
groups = {public},
institution = {MRC/UCT Medical Imaging Research Unit, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, South Africa. Nellekelangerak@hotmail.com},
interhash = {f2d2531f31ee7f713b8053587e21dc77},
intrahash = {5a3c82e4a73a16eecaa86005aeb1567c},
journal = {Gait Posture},
keywords = {Adolescent; Adult; Age Factors; Ankle Joint, physiopathology; Biomechanics; Case-Control Studies; Cerebral Palsy, complications/diagnosis/surgery; Disability Evaluation; Female; Follow-Up Gait Disorders, Neurologic, etiology/physiopathology; Gait, physiology; Hip Humans; Knee Male; Middle Aged; Orthopedic Procedures, methods; Patient Selection; Range of Motion, Articular, Reference Values; Rhizotomy, Risk Assessment; Severity Illness Index; Task Performance and Analysis; Time Young Adult},
language = {eng},
medline-pst = {ppublish},
month = Feb,
number = 2,
pages = {244--249},
pii = {S0966-6362(11)00298-0},
pmid = {22050972},
timestamp = {2014-07-19T20:40:34.000+0200},
title = {Gait status 17-26 years after selective dorsal rhizotomy.},
url = {http://dx.doi.org/10.1016/j.gaitpost.2011.09.014},
username = {ar0berts},
volume = 35,
year = 2012
}