Selective dorsal rhizotomy, a surgery that lessens spasticity (muscle stiffness) in children with cerebral palsy, does not reduce their energy consumption during walking, a retrospective study has found.
The study, “Spasticity reduction in children with cerebral palsy is not associated with reduced energy consumption during walking,” was published in the preprint server BioRxiv.
Children with cerebral palsy (CP) expend, on average, over two times the energy to walk than typically developing children. As a result, fatigue is a top complaint of these children and reported by their families.
Spasticity, or muscle stiffness, has been proposed as the root cause for this extra energy consumption, but this link remains to be established.
Spasticity can cause an increase in overall muscle activity and is observed in up to 80% of children with cerebral palsy.
To better understand whether spasticity can be a significant contributor to the observed increase in energy consumption during walking, researchers at the University of Washington and University of Minnesota, Twin Cities, investigated if reducing spasticity could lower energy consumption in children with cerebral palsy.
The team retrospectively compared the energy spent in walking by 242 children with diplegic CP — a form of the disease marked by spasticity — before and after they had selective dorsal rhizotomy (SDR). SDR is a neurosurgical procedure involving the sectioning of some sensory nerve fibers that come from the muscles and enter the spinal cord. The surgery has been shown to reduce spasticity significantly.
The study used retrospective data from clinical gait analysis of children seen at Gillette Children’s Specialty Healthcare between 1994 and 2018. All participants underwent a bilateral SDR before the age of 12.