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Article
The first meta-analysis of randomized controlled surgical trials in cerebral palsy (2002)
Dev Med Child Neurol
  • Robert Armstrong, Aga Khan University
Publication Date
1-1-2008
Document Type
Article
Disciplines
Abstract
This study is a comparative analysis and meta-analysis of three randomized clinical trials. Children with spastic diplegia received either 'selective' dorsal rhizotomy (SDR) plus physiotherapy (SDR+PT) or PT without SDR (PT-only). Common outcome measures were used for spasticity (Ashworth scale) and function (Gross Motor Function Measure [GMFM]). Baseline and 9- to 12-month outcome data were pooled (n=90). At baseline, 82 children were under 8 years old and 65 had Gross Motor Function Classification System level II or III disability. Pooled Ashworth data analysis confirmed a reduction of spasticity with SDR+PT (mean change score difference -1.2; Wilcoxon p<0.001). Pooled GMFM data revealed greater functional improvement with SDR+PT (difference in change score +4.0, p=0.008). Multivariate analysis in the SDR+PT group revealed a direct relationship between percentage of dorsal root tissue transected and functional improvement. SDR+PT is efficacious in reducing spasticity in children with spastic diplegia and has a small positive effect on gross motor function.
Citation Information
Robert Armstrong. "The first meta-analysis of randomized controlled surgical trials in cerebral palsy (2002)" Dev Med Child Neurol Vol. 50 Iss. 4 (2008)
Available at: http://works.bepress.com/robert_armstrong/1/