Abstract：
BACKGROUND: Children with spastic diplegia experience tonicity, lack of selective motor control, subnormal postural stability and delayed motor development. Selective dorsal rhizotomy followed by physical therapy is a permanent procedure aimed to alleviate hypertonicity.
OBJECTIVE: To explore the efficacy of selective dorsal rhizotomy (SDR) followed by a physical training on gross motor function (GMF), functional balance, walking capacity, selective motor control (SMC) and energy cost of walking (ECW) of ambulant children with spastic diplegia.
METHODS: Forty-two children with spastic diplegia aged 5 to 8 years were randomly assigned into the control or SDR-group. Both groups received a designed physical training of progressive functional strength training and standard orthotic management (SOM) 3 times a week for 6 months. GMF, functional balance, ECW, functional capacity and SMC were assessed by gross motor function measure (GMfM-88), pediatric balance scale (PBS), energy expenditure index (EEI), six-minute walking test (6MWT) and selective control assessment of lower extremity (SCALE), respectively. Assessment was carried out before the treatment (baseline), after 6 months (post I) and 1-year follow-up (post II).
RESULTS: From baseline to post I and post II assessments, changes of GMF, functional balance, ECW, functional capacity and SMC within the control and SDR groups showed significant improvements (P < 0.001). Moreover, group comparison showed significant differences in favor of the SDR group.
CONCLUSIONS: Integrated physical training followed SDR demonstrated qualitative changes and enhancement in motor function, achieved by spasticity reduction.
OBJECTIVE: To explore the efficacy of selective dorsal rhizotomy (SDR) followed by a physical training on gross motor function (GMF), functional balance, walking capacity, selective motor control (SMC) and energy cost of walking (ECW) of ambulant children with spastic diplegia.
METHODS: Forty-two children with spastic diplegia aged 5 to 8 years were randomly assigned into the control or SDR-group. Both groups received a designed physical training of progressive functional strength training and standard orthotic management (SOM) 3 times a week for 6 months. GMF, functional balance, ECW, functional capacity and SMC were assessed by gross motor function measure (GMfM-88), pediatric balance scale (PBS), energy expenditure index (EEI), six-minute walking test (6MWT) and selective control assessment of lower extremity (SCALE), respectively. Assessment was carried out before the treatment (baseline), after 6 months (post I) and 1-year follow-up (post II).
RESULTS: From baseline to post I and post II assessments, changes of GMF, functional balance, ECW, functional capacity and SMC within the control and SDR groups showed significant improvements (P < 0.001). Moreover, group comparison showed significant differences in favor of the SDR group.
CONCLUSIONS: Integrated physical training followed SDR demonstrated qualitative changes and enhancement in motor function, achieved by spasticity reduction.
摘要：
背景：患有痉挛性双瘫的儿童有张力，缺乏选择性电机控制，低于正常的姿势稳定性和延迟的运动发育。选择性背根切断术，然后进行物理治疗是一种旨在缓解高渗性的永久性手术。
目的：探讨选择性背根切断术（SDR）后进行体育锻炼对粗大运动功能（GMF）的疗效。功能平衡，步行能力,选择性运动控制（SMC）和步行能量成本（ECW）的非卧床儿童痉挛双瘫。
方法：将42名5至8岁的痉挛型双瘫患儿随机分为对照组或SDR组。两组均接受设计的体能训练，包括渐进式功能力量训练和标准矫形管理（SOM），每周3次，为期6个月。GMF,功能平衡，ECW,通过粗大运动功能测量(GMfM-88)评估功能容量和SMC，儿科平衡量表（PBS），能量消耗指数(EEI)，六分钟步行测试（6MWT）和下肢选择性控制评估（SCALE），分别。在治疗前（基线）进行评估，6个月后（I后）和1年随访（II后）。
结果：从基线到I后和II后评估，GMF的变化，功能平衡，ECW,对照组和SDR组的功能容量和SMC显着改善（P<0.001）。此外，组比较显示差异显著有利于SDR组。
结论：SDR之后的综合体育锻炼显示出质变和运动功能增强，通过减少痉挛来实现。
目的：探讨选择性背根切断术（SDR）后进行体育锻炼对粗大运动功能（GMF）的疗效。功能平衡，步行能力,选择性运动控制（SMC）和步行能量成本（ECW）的非卧床儿童痉挛双瘫。
方法：将42名5至8岁的痉挛型双瘫患儿随机分为对照组或SDR组。两组均接受设计的体能训练，包括渐进式功能力量训练和标准矫形管理（SOM），每周3次，为期6个月。GMF,功能平衡，ECW,通过粗大运动功能测量(GMfM-88)评估功能容量和SMC，儿科平衡量表（PBS），能量消耗指数(EEI)，六分钟步行测试（6MWT）和下肢选择性控制评估（SCALE），分别。在治疗前（基线）进行评估，6个月后（I后）和1年随访（II后）。
结果：从基线到I后和II后评估，GMF的变化，功能平衡，ECW,对照组和SDR组的功能容量和SMC显着改善（P<0.001）。此外，组比较显示差异显著有利于SDR组。
结论：SDR之后的综合体育锻炼显示出质变和运动功能增强，通过减少痉挛来实现。
