Comparison of outcomes following surgical intervention and inpatient rehabilitation stays in children with cerebral palsy

Abstract

AbstractIntroductionLiterature is limited on functional outcomes in children with cerebral palsy (CP) following surgical procedures and a subsequent inpatient rehabilitation unit (IRU) stay.ObjectiveTo compare functional outcomes and length of stay (LOS) in children with CP following a surgical procedure and IRU stay based on the surgical procedure performed, pattern of involvement, etiology, and Gross Motor Function Classification System (GMFCS) level.DesignRetrospective cohort study.SettingTertiary care pediatrics.ParticipantsPediatric patients with CP who underwent one of three surgical procedures followed by an IRU stay.InterventionsSelective dorsal rhizotomy (SDR), single‐event multilevel orthopedic surgery (SEMLS), or intrathecal baclofen (ITB) pump implantation and subsequent IRU stay.Main Outcome MeasuresIRU LOS, Functional Independence Measure for Children (WeeFIM) total score, sub‐scores, and efficiency.ResultsChildren undergoing SDR had a longer LOS (p ≤ .015). Children with spastic diplegia, GMFCS level II, and prematurity‐based CP had higher WeeFIM efficiency scores (p ≤ .046, ≤.021, and .034 respectively). Greater changes in WeeFIM™ scores were associated with spastic diplegia, SDR, GMFCS level II, longer LOS, and higher admission scores (p ≤ .045).ConclusionsAlthough statistically and functionally significant improvements in children with CP following surgical interventions and an IRU stay were seen, those with higher WeeFIM change scores tended to have spastic diplegia, to have undergone SDR, GMFCS level II, longer LOS, and higher admission scores.