Advertisement for orthosearch.org.uk
Orthopaedic Proceedings Logo

Receive monthly Table of Contents alerts from Orthopaedic Proceedings

Comprehensive article alerts can be set up and managed through your account settings

View my account settings

Visit Orthopaedic Proceedings at:

Loading...

Loading...

Full Access

LOSS OF MUSCLE STRENGTH IN CHILDREN WITH CEREBRAL PALSY/SPASTIC DIPLEGIA FOLLOWING MULTILEVEL ORTHOPAEDIC SURGERY



Abstract

Introduction: The purpose of this study was to quantify changes in lower limb muscle strength in children with spastic diplegic cerebral palsy 6 months after multi-level orthopaedic surgery.

Method: A consecutive sample of 20 children ( 10 girls and 10 boys, mean age 10.6) with spastic diplegia was studied prospectively. All participants had soft-tissue and bony surgical procedures performed as part of their clinical management. Physiotherapy treatment commenced following surgery. Lower limb muscle strength, pre and 6 months post-surgery, was measured, in addition to routine gait and function assessment. Maximum voluntary isometric strength of 5 muscle groups was measured bilaterally using a digital dynamometer. Paired-samples t-tests were performed.

Results: There was a marked deterioration of muscle strength (p < 0.05) in all muscle groups. Medial hamstrings and hip flexors showed the greatest decline with an average decrease of 54% and 41% respectively. Analysis of gait parameters showed a significant improvement in kinematics (p< 0.05) but a decrease in walking velocity and cadence. Motor function decreased significantly (p< 0.05). There was reduced motor power in 18 of the 20 at 6 months.

Discussion: Our results quantified objectively the magnitude of strength changes after multi-level surgery and show that weakness may be greater and persist longer than expected. This information will be useful for planning treatment after multi-level surgery and is part of a randomised trial investigating strength training. In general there is a decrease in power but an improvement in gait.

Correspondence should be addressed to BSCOS, c/o Royal College of Surgeons, 35 – 43 Lincoln’s Inn Fields, London, WC2A 3PN