ABSTRACT
We prospectively case series study evaluated the short-term effectiveness of selective dorsal rhizotomy plus physiotherapy. Twenty children with spastic cerebral palsy, selected for selective dorsal rhizotomy (mean age, 8.57 years; range, 5.96-11.18 years), were assessed before, and 6 and 12 months after, selective dorsal rhizotomy. Main outcome measures included the Modified Ashworth Scale, passive range of joint movement, the Gross Motor Function Measure, the Pediatric Evaluation of Disability Inventory, the Canadian Occupational Performance Measure, and three-dimensional gait analysis. The results confirmed that selective dorsal rhizotomy plus physiotherapy provided a statistically significant reduction of spasticity, functional improvements in mobility and self-care performance, and increased participation in social situations in our study group (85% exhibited normal intelligence, and 90% belonged to Gross Motor Function Classification System levels I-III). The Gross Motor Function Measure proved to be sensitive in documenting motor functional changes, except for children at Gross Motor Function Classification System level I. Instrumental three-dimensional gait analysis with kinematics and kinetics data analysis confirmed gait improvements in children of higher motor function. The Canadian Occupational Performance Measure indicated improvements in social participation.
Subject(s)
Cerebral Palsy/therapy , Rhizotomy , Spinal Nerve Roots/surgery , Activities of Daily Living , Biomechanical Phenomena , Cerebral Palsy/psychology , Cerebral Palsy/surgery , Child , Combined Modality Therapy , Female , Gait , Hong Kong , Humans , Intelligence Tests , Male , Motor Activity , Muscle Strength/physiology , Physical Therapy Modalities , Postural Balance/physiology , Posture/physiology , Prospective Studies , Treatment Outcome , Walking/physiologyABSTRACT
OBJECTIVE: To report the clinical profile of children with mental retardation and developmental delay diagnosed by the Child Assessment Service. DESIGN: Retrospective study. SETTING: Child Assessment Service, Department of Health, Hong Kong. PARTICIPANTS: Data pertaining to the children with mental retardation and developmental delay were drawn from an in-house clinical information system in the year 2004. MAIN OUTCOME MEASURES: Clinical profiles including: sources, reasons and age of referral, diagnosis, gender ratio, co-morbidities, and socio-economic background. RESULTS: In 2004, 23% (1463 of 6439) of Child Assessment Service referrals were diagnosed to have mental retardation or developmental delay. The Family Health Service was the major source of referral (64%). The majority (93%) of children were referred before the age of 6 years. The most common reason for referral was language delay (39%). More boys were affected (3 boys: 1 girl). The two most common co-morbidities were autistic spectrum disorders (33% in mental retardation and 19% in developmental delay) and discrepant language delay (17% in mental retardation and 47% in developmental delay). The socio-economic status of these families was higher than those in the general population. CONCLUSION: The data presented here provide information on the descriptive epidemiology of mental retardation and developmental delay among Hong Kong children. Since mental retardation and developmental delay are common developmental disabilities in Hong Kong, public health education to promote and ensure early screening and identification of cases is an important prelude to early training and guidance for families with children having these conditions.
