The effect of hip reconstruction on gross motor function levels in children with cerebral palsy

Objective: The aim of this study was to determine whether the hip reconstruction has an effect on gross motor function classification system (GMFCS) levels in patients with hip instability in cerebral palsy (CP). Methods: A total of 45 hips of 30 patients (mean age: 8.7 (4–17) years) with CP operate...

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Main Authors: Mutlu Cobanoglu, Emre Cullu, Imran Omurlu
Format: Article
Language:English
Published: AVES Yayincilik 2018-01-01
Series:Acta Orthopaedica et Traumatologica Turcica
Online Access:http://www.sciencedirect.com/science/article/pii/S1017995X16303601
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spelling doaj-ba814a215646468b954045ca5363d0292020-11-25T01:25:05ZengAVES YayincilikActa Orthopaedica et Traumatologica Turcica1017-995X2018-01-015214448The effect of hip reconstruction on gross motor function levels in children with cerebral palsyMutlu Cobanoglu0Emre Cullu1Imran Omurlu2Adnan Menderes University, Faculty of Medicine, Department of Orthopedics and Traumatology, Aydın, Turkey; Corresponding author. Adnan Menderes University, Faculty of Medicine, Department of Orthopedics and Traumatology, Kepez Mevkii 09100, Aydın, Turkey. Fax: +90 2562197163.Adnan Menderes University, Faculty of Medicine, Department of Orthopedics and Traumatology, Aydın, TurkeyAdnan Menderes University, Faculty of Medicine, Department of Biostatistics, Aydın, TurkeyObjective: The aim of this study was to determine whether the hip reconstruction has an effect on gross motor function classification system (GMFCS) levels in patients with hip instability in cerebral palsy (CP). Methods: A total of 45 hips of 30 patients (mean age: 8.7 (4–17) years) with CP operated due to hip instability with a minimum of 2 years of follow-up were included into the study. Migration index was used for classification of the severity of hip instability. Clinical evaluation included sitting and walking ability, existence of pressure sores, difficulty in perineal care, and hip pain. The functional gains from the surgery were evaluated with changes in GMFCS levels. Wilcoxon T test, chi-square test and Spearman correlation test were used. Results: Mean follow-up time was 57 (24–132) months. The distribution of preoperative GMFCS was level I in 1 patient, level II in 4 patients, level III in 5 patients, level IV in 9 patients and level V in 11 patients. The complaints resolved in 25 patients, and persisted in 5 postoperatively. There was no correlation between the changes in GMFCS levels and the postoperative complaints (p = 0.504). The GMFCS levels did not change in 20 patients, improved in 8, and worsened in 2. There were no significant differences between the preoperative and postoperative GMFCS levels (p = 0.052). Positive correlations were found between the preoperative GMFCS-MI, the type of CP-MI respectively (p = 0.001, p = 0.015). Conclusion: There was an improvement in preoperative complaints. GMFCS levels remained stable after surgery. Relief in symptoms was not consistent with the changes in GMFCS in children with cerebral palsy after hip reconstruction. Level of evidence: Level IV, Therapeutic study. Keywords: Cerebral palsy, Hip reconstruction, Gross motor function, Classification systemhttp://www.sciencedirect.com/science/article/pii/S1017995X16303601
collection DOAJ
language English
format Article
sources DOAJ
author Mutlu Cobanoglu
Emre Cullu
Imran Omurlu
spellingShingle Mutlu Cobanoglu
Emre Cullu
Imran Omurlu
The effect of hip reconstruction on gross motor function levels in children with cerebral palsy
Acta Orthopaedica et Traumatologica Turcica
author_facet Mutlu Cobanoglu
Emre Cullu
Imran Omurlu
author_sort Mutlu Cobanoglu
title The effect of hip reconstruction on gross motor function levels in children with cerebral palsy
title_short The effect of hip reconstruction on gross motor function levels in children with cerebral palsy
title_full The effect of hip reconstruction on gross motor function levels in children with cerebral palsy
title_fullStr The effect of hip reconstruction on gross motor function levels in children with cerebral palsy
title_full_unstemmed The effect of hip reconstruction on gross motor function levels in children with cerebral palsy
title_sort effect of hip reconstruction on gross motor function levels in children with cerebral palsy
publisher AVES Yayincilik
series Acta Orthopaedica et Traumatologica Turcica
issn 1017-995X
publishDate 2018-01-01
description Objective: The aim of this study was to determine whether the hip reconstruction has an effect on gross motor function classification system (GMFCS) levels in patients with hip instability in cerebral palsy (CP). Methods: A total of 45 hips of 30 patients (mean age: 8.7 (4–17) years) with CP operated due to hip instability with a minimum of 2 years of follow-up were included into the study. Migration index was used for classification of the severity of hip instability. Clinical evaluation included sitting and walking ability, existence of pressure sores, difficulty in perineal care, and hip pain. The functional gains from the surgery were evaluated with changes in GMFCS levels. Wilcoxon T test, chi-square test and Spearman correlation test were used. Results: Mean follow-up time was 57 (24–132) months. The distribution of preoperative GMFCS was level I in 1 patient, level II in 4 patients, level III in 5 patients, level IV in 9 patients and level V in 11 patients. The complaints resolved in 25 patients, and persisted in 5 postoperatively. There was no correlation between the changes in GMFCS levels and the postoperative complaints (p = 0.504). The GMFCS levels did not change in 20 patients, improved in 8, and worsened in 2. There were no significant differences between the preoperative and postoperative GMFCS levels (p = 0.052). Positive correlations were found between the preoperative GMFCS-MI, the type of CP-MI respectively (p = 0.001, p = 0.015). Conclusion: There was an improvement in preoperative complaints. GMFCS levels remained stable after surgery. Relief in symptoms was not consistent with the changes in GMFCS in children with cerebral palsy after hip reconstruction. Level of evidence: Level IV, Therapeutic study. Keywords: Cerebral palsy, Hip reconstruction, Gross motor function, Classification system
url http://www.sciencedirect.com/science/article/pii/S1017995X16303601
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