Evaluation of gross motor function classification system (GMFCS) improvement after selective myofascial release for the treatment of cerebral palsy

• Main Authors: P. Eamsobhana, O. Chalayon, T. Luanglert
• Other Authors: Faculty of Medicine, Siriraj Hospital, Mahidol University
• Format: Article
• Published: 2020
• Subjects: Medicine
• Online Access: https://repository.li.mahidol.ac.th/handle/123456789/52231
• Institution: Mahidol University

© 2019 Medical Association of Thailand. All rights reserved. Background: Cerebral palsy (CP), which results from a non-progressive injury that occurs during brain development, is the most common movement disorder in children. Objective: To evaluate the improvement in Gross Motor Function Classification System (GMFCS) status after orthopedic surgical intervention in children with spastic CP. Material and Methods: This retrospective chart review included spastic cerebral palsy patients aged 7 to 11 years who underwent lower extremity soft tissue release during 2009 to 2014. All patients had complete pre-operative and post-operative data with a minimum follow-up of 2 years. Patients were re-evaluated at 2-years postoperatively for GMFCS level, and those results were compared with pre-operative function. Results: Of the 92 study participants, the pre-operative GMFCS level was II in 48, III in 14, and IV in 30 patients. The mean age at first evaluation was 7.61+1.93 years. Seventy-five percent of patients with GMFCS level II remained at their preoperative level at surgery. Fifty-seven percent of patients with GMFCS level III improved to GMFCS level II. Twelve patients (40%) with GMFCS level IV improved to level III, and 2 patients (6.67%) improved from GMFCS IV to GMFCS II. However, none of the aforementioned improvements in GMFCS category were statistically significant. No significant association was observed between improvement in GMFCS level and gender, pre-operative or postoperative popliteal angle, and number or type of operation. Conclusion: In the present study, 42.9% of patients in GMFCS III and 53.3% of patients in GMFCS IV showed improvement in GMFCS level after soft tissue surgery at the lower extremities. Almost half (44.12%) of patients who had multilevel operations demonstrated improvement in GMFCS, but the improvement was not statistically significant.