Evaluation of single event multilevel surgery and rehabilitation in children and youth with cerebral palsy – A 2-year follow-up study

Abstract

Purpose. This study evaluated multilevel surgery and rehabilitation with functional measures and health related quality of life (HRQOL) of children and youth with cerebral palsy (CP). In addition this study evaluated parent's satisfaction with care.

Method. A prospective single-subject study with AB design and 2-year follow-up, included 11 children between 8 and 18 years old with CP, Gross Motor Function Classification System I–III. Visual analyses were used to present physical function with Physical Cost Index (PCI). Descriptive statistics were used to present number of children with a clinically important change in Gross Motor Function Measure (GMFM), self-reported walking ability, and HRQOL with child health questionnaire (CHQ).

Results. PCI showed a trend of lower energy cost during gait in six children and GMFM was unchanged for 10 children and improved for one child. Walking ability was improved in 10 children. Gait distance increased in all 11. Both physical and psychosocial dimensions of CHQ improved in six of nine (two missing data). Expectations of outcomes were fulfilled in seven and partly fulfilled in four. Satisfaction with care was fulfilled in 10 of 11.

Conclusion. Self-reported walking ability improved after multilevel surgery and intensive rehabilitation. This result was partly supported by lower energy cost and improved HRQOL. Expectations and satisfaction were fulfilled for the majority of children.

Keywords:

• Cerebral palsy
• children
• multilevel surgery
• outcome
• life quality
• care

Acknowledgements

A special thanks to the participating children and their parents for making this study possible. Thanks to orthopedic-surgeon Stefan Lind and all colleagues at the habilitation centers. This study was supported by FORSS, the research council in southeast of Sweden and Futurum Ryhov, Jönköping.