Impact of Occupational Therapy on Self-Care After Selective Dorsal Rhizotomy Among Children With Cerebral Palsy.

IMPORTANCE: Selective dorsal rhizotomy (SDR) is an established treatment for spastic cerebral palsy (CP). The effects and predictors of occupational therapy's benefit for self-care after SDR in children with CP have not been thoroughly investigated. OBJECTIVE: To identify changes in self-care after occupational therapy post-SDR and determine whether changes were affected by age, Gross Motor Function Classification System (GMFCS) level, and number of occupational therapy dressing sessions. DESIGN: In this retrospective cohort study, we collected outcomes pre-SDR, at discharge, and at 1-yr follow-up. Paired t tests and regression analysis were performed. SETTING: Commission on Accreditation of Rehabilitation Facilities-accredited pediatric inpatient rehabilitation facility. PARTICIPANTS: Seventy-three children (GMFCS Levels I-III, ages 4-17 yr) diagnosed with spastic CP who underwent SDR from 2014 to 2018. INTERVENTION: After having SDR, each child received an average of twice daily occupational therapy for an average of 37.3 days. OUTCOMES AND MEASURES: The Pediatric Evaluation of Disability Inventory Computer Adaptive Test (PEDI-CAT) and Functional Independence Measure for Children® (WeeFIM) were used to assess self-care performance. RESULTS: The mean WeeFIM dressing (upper and lower body) and mean PEDI-CAT daily activities scores from baseline to discharge and mean WeeFIM lower body dressing at 1-yr follow-up improved significantly. The improvement in lower body dressing correlated with GMFCS level and the number of occupational therapy dressing sessions. CONCLUSIONS AND RELEVANCE: The improvement in upper and lower extremity dressing and PEDI-CAT daily activities scores suggests that inpatient occupational therapy post-SDR may provide benefits. What This Article Adds: Children diagnosed with CP may undergo surgical interventions to improve their ability to walk. This article demonstrates the benefit of occupational therapy services after SDR to improve upper and lower body dressing skills.

Modified constraint-induced movement therapy for a 12-month-old child with hemiplegia: a case report.

OBJECTIVE: This case report describes the use of modified constraint-induced movement therapy (CIMT) to improve upper-limb function in a 12-month-old child with right hemiplegia. It also describes parent concerns about CIMT and documents the short- and long-term effects of modified CIMT. METHOD: The participant was assessed 5 times over a 7.5-month period using the Peabody Developmental Motor Scales-2, Pediatric Motor Activity Log, Toddler Amount of Use Test, and Knox Parent Questionnaire. CIMT included a nonremovable cast worn on the unaffected arm and approximately 8 hr per week of occupational and physical therapy for 2 weeks. RESULTS: Benefits of improved upper-limb function measured immediately after CIMT were sustained at 6 months' follow-up. No adverse events related to cast use were reported. DISCUSSION: The findings from this case report suggest that CIMT was a safe intervention associated with improving upper-limb function for this young child with hemiplegia.