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ORIGINAL ARTICLE
Year : 2018  |  Volume : 2  |  Issue : 4  |  Page : 148-155

Single-event multilevel surgery for crouching cerebral palsy children: Correlations with quality of life and functional mobility


1 Department of Orthopedic Surgery, Division of Pediatric Orthopedics and Limb Reconstruction, Faculty of Medicine, Ain-Shams University, Cairo, Egypt
2 Department of Rheumatology and Rehabilitation, Division of Pediatric Rehabilitation, Faculty of Medicine, Ain-Shams University, Cairo, Egypt

Correspondence Address:
Dr. John Amen
Department of Orthopedic Surgery, Division of Pediatric Orthopedics and Limb Reconstruction, Faculty of Medicine, Ain-Shams University, Cairo
Egypt
Tamer A. El-Sobky
Department of Orthopedic Surgery, Division of Pediatric Orthopedics and Limb Reconstruction, Faculty of Medicine, Ain-Shams University, Cairo
Egypt
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jmsr.jmsr_48_18

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Objectives: Crouch gait in cerebral palsy (CP) is characterized by excessive knee flexion throughout stance. Single-event multilevel orthopedic surgery is the standard of care to improve gait and function through correcting lever arm deformities in children with CP. A limited number of prospective studies on single-event multilevel orthopedic surgery for crouching CP children are available. We intended to evaluate the effectiveness of single-event multilevel surgery (SEMLS) regarding functional mobility, energy consumption during gait, and the mental, attitudinal, and lifestyle status of CP children with crouch gait on the short term. Methods: Thirty-four limbs in 18 children with bilateral spastic and crouching CP were enrolled prospectively and subjected to SEMLS. The mean age was 12 years (range, 5.5–18). Outcome measures included clinical couch examination parameters, walking speed, physiological cost index (PCI), functional mobility scale (FMS), and the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0). In addition, we used instrumented three-dimensional gait analysis as an outcome measure for some participants. Results: At a mean follow-up of 16 months (range, 12–22), the couch examination parameters, FMS at 5, 50, and 500 m, walking speed, PCI, and WHODAS 2.0 score showed a highly statistically significant improvement (P < 0.01). Conclusions: SEMLS for CP children and adolescents with crouch gait is effective for improving function, independence, energy consumption, and quality of life on the short term.


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