A Systematic Review of the Effects of Single-Event Multilevel Surgery on Gait Parameters in Children with Spastic Cerebral Palsy

Overview

Journal PLoS One

Specialties General Medicine
Science

Date 2016 Oct 19

PMID 27755599

Citations 14

Authors

Robert P Lamberts

Marlette Burger

Jacques Du Toit

Nelleke G Langerak

Affiliations

Soon will be listed here.

Abstract

Background: Three-dimensional gait analysis (3DGA) is commonly used to assess the effect of orthopedic single-event multilevel surgery (SEMLS) in children with spastic cerebral palsy (CP).

Purpose: The purpose of this systematic review is to provide an overview of different orthopedic SEMLS interventions and their effects on 3DGA parameters in children with spastic CP.

Methods: A comprehensive literature search within six databases revealed 648 records, from which 89 articles were selected for the full-text review and 24 articles (50 studies) included for systematic review. The Oxford Centre for Evidence-Based Medicine Scale and the Methodological Index for Non-Randomized Studies (MINORS) were used to appraise and determine the quality of the studies.

Results: Except for one level II study, all studies were graded as level III according to the Oxford Centre for Evidence-Based Medicine Scale. The MINORS score for comparative studies (n = 6) was on average 15.7/24, while non-comparative studies (n = 18) scored on average 9.8/16. Nineteen kinematic and temporal-distance gait parameters were selected, and a majority of studies reported improvements after SEMLS interventions. The largest improvements were seen in knee range of motion, knee flexion at initial contact and minimal knee flexion in stance phase, ankle dorsiflexion at initial contact, maximum dorsiflexion in stance and in swing phase, hip rotation and foot progression angles. However, changes in 3DGA parameters varied based on the focus of the SEMLS intervention.

Discussion: The current article provides a novel overview of a variety of SEMLS interventions within different SEMLS focus areas and the post-operative changes in 3DGA parameters. This overview will assist clinicians and researchers as a potential theoretical framework to further improve SEMLS techniques within different SEMLS focus groups. In addition, it can also be used as a tool to enhance communication with parents, although the results of the studies can't be generalised and a holistic approach is needed when considering SEMLS in a child with spastic CP.

Citing Articles

Case report: Intensive rehabilitation program delivered before and after single-event multilevel surgery in a girl with diplegic cerebral palsy.

Crecchi A, Tozzini A, Benedetti R, Maltinti M, Bonfiglio L Front Neurol. 2024; 14:1323697.

PMID: 38283677 PMC: 10811248. DOI: 10.3389/fneur.2023.1323697.

A 10.5-year follow-up of walking with unilateral spastic cerebral palsy.

Bonnefoy-Mazure A, De Coulon G, Lascombes P, Bregou A, Armand S J Child Orthop. 2023; 17(2):173-183.

PMID: 37034199 PMC: 10080234. DOI: 10.1177/18632521231154975.

Effect of an augmented reality active video game for gait training in children with cerebral palsy following single-event multilevel surgery: protocol for a randomised controlled trial.

Guinet A, Bams M, Payan-Terral S, Khouri N, Otmane S, Bouyer G BMJ Open. 2022; 12(10):e061580.

PMID: 36216413 PMC: 9558782. DOI: 10.1136/bmjopen-2022-061580.

A core outcome set for lower limb orthopaedic surgery for children with cerebral palsy: An international multi-stakeholder consensus study.

Almoajil H, Hopewell S, Dawes H, Toye F, Theologis T Dev Med Child Neurol. 2022; 65(2):254-263.

PMID: 35869637 PMC: 10084115. DOI: 10.1111/dmcn.15351.

Short-term causal effects of common treatments in ambulatory children and young adults with cerebral palsy: three machine learning estimates.

Schwartz M, Ries A, Georgiadis A Sci Rep. 2022; 12(1):7818.

PMID: 35551496 PMC: 9098860. DOI: 10.1038/s41598-022-11875-5.

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