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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)
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| control group | Other | control group |
|
| Experimental group | Experimental | selective dorsal rhizotomy group |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Concomitant physical rehabilitation | Other | 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. |
| Measure | Description | Time Frame |
|---|---|---|
| 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. | after 6 months and after 1 year (follow-up) |
| Gross motor function | The gross motor function measure-88 is used to evaluate the motor function with total score is 100 and higher scores representing a better performance. | after 6 months and after 1 year (follow-up) |
| Measure | Description | Time Frame |
|---|---|---|
| Selective voluntary motor control | Selective motor control of lower extremity scale is used for assessment of motor control of the lower limb joints in children with spastic cerebral palsy with a maximum score of 20 points, 10 points for each limb. | after 6 months and after 1 year (follow-up) |
| Energy cost of walking |
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Inclusion Criteria:
Exclusionary criteria
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| Name | Affiliation | Role |
|---|---|---|
| Hazem A Aly, Phd | PhD of physical therapy for pediatrics, faculty of physical therapyCairo university | Study Chair |
| Ahmed Rabie, Phd | Department of neurosurgery, faculty of medicine , Alexandria university | Study Director |
| Sara S Saad-Eldien, PhD | Cairo university, faculty of physical therapy | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Amira Mahmoud Abd-elmonem | Giza | 12662 | Egypt |
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|
| Standard Orthotic Management | Other | 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 | Other | The surgical procedures were tailored to each child according to preoperative assessment plan. All SDRs were performed by a single neurosurgeon through an osteoplastic laminotomy from L2 to L5 that left the facet joints intact. |
|
The energy expenditure index (beats/meter) can be calculated as; walking heart rate (beats/min) minus resting heart rate (beats/ min) on walking velocity (meters/min). |
| after 6 months and after 1 year (follow-up) |
| Functional capacity | The six-minute walking test is used to assess walking capacity in children with and without disabilities. | after 6 months and after 1 year (follow-up) |
| ID | Term |
|---|---|
| D002547 | Cerebral Palsy |
| ID | Term |
|---|---|
| D001925 | Brain Damage, Chronic |
| D001927 | Brain Diseases |
| D002493 | Central Nervous System Diseases |
| D009422 | Nervous System Diseases |
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