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Assessment of spastic patients before and after selective posterior lumbar rhizotomy
For many decades people working with spastic patients have searched for better methods of alleviating spasticity and its debilitating effects. Although many methods have been used, no single method has been completely successful. It was not until the nineteen seventies that Selective Posterior Lumba...
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| Format: | Thesis |
| Language: | English |
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Division of Occupational Therapy
2017
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| _version_ | 1867613244664840193 |
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| access_status_str | Open Access |
| author | Berman, Barbara |
| author2 | Vaughan, Christopher Leonard (Kit) |
| author_browse | Berman, Barbara Vaughan, Christopher Leonard (Kit) |
| author_facet | Vaughan, Christopher Leonard (Kit) Berman, Barbara |
| author_sort | Berman, Barbara |
| collection | Thesis |
| description | For many decades people working with spastic patients have searched for better methods of alleviating spasticity and its debilitating effects. Although many methods have been used, no single method has been completely successful. It was not until the nineteen seventies that Selective Posterior Lumbar Rhizotomy (SPLR) was used successfully with spastic patients. In 1980 Peacock started doing this procedure on a large number of spastic patients in South Africa. I became interested in SPLR after seeing the dramatic reduction in spasticity and the improvement in function in my patients who had undergone the procedure. Since observations of improvement up to this point had been subjective, I decided to measure and document the physical status of patients before and after surgery. Twenty-nine patients who underwent Selective Posterior Lumbar Rhizotomy in 1985 were studied. In order to be as objective as possible, crawling and gait analyses were done in addition. All the patients were assessed clinically two days prior to surgery and then between four and fourteen months after surgery. For both preoperative and postoperative assessments, resistance to passive movement, degree of joint stiffness, ability to initiate and inhibit voluntary movement, and the degree of abnormal function in the developmental positions (rolling, sitting, kneeling, crawling, standing and walking) were graded on rating scales. Analyses of gait and crawling were done using a digital camera system. Results of the study indicated that SPLR produced a statistically significant reduction in muscle tone and in joint stiffness. Improvements in voluntary movement and functional movement (rolling, sitting, kneeling, crawling, standing and walking) were also statistically significant. It was concluded that Selective Posterior Lumbar Rhizotomy is a useful method of reducing spasticity and results in improvement of the quality of life in patients with spastic cerebral palsy. |
| format | Thesis |
| id | oai:open.uct.ac.za:11427/25839 |
| institution | University of Cape Town (South Africa) |
| language | eng |
| last_indexed | 2026-06-10T12:33:04.194Z |
| license_str | Not specified — see source repository |
| provenance_str_mv | Harvested via OAI-PMH from UCTD — University of Cape Town Open Access Repository |
| publishDate | 2017 |
| publishDateRange | 2017 |
| publishDateSort | 2017 |
| publisher | Division of Occupational Therapy |
| publisherStr | Division of Occupational Therapy |
| record_format | dspace |
| source_str | UCTD — University of Cape Town Open Access Repository |
| spelling | oai:open.uct.ac.za:11427/25839 Assessment of spastic patients before and after selective posterior lumbar rhizotomy Berman, Barbara Vaughan, Christopher Leonard (Kit) Spasticity - Surgery Nerves, Spinal - Roots - Surgery Occupational Therapy For many decades people working with spastic patients have searched for better methods of alleviating spasticity and its debilitating effects. Although many methods have been used, no single method has been completely successful. It was not until the nineteen seventies that Selective Posterior Lumbar Rhizotomy (SPLR) was used successfully with spastic patients. In 1980 Peacock started doing this procedure on a large number of spastic patients in South Africa. I became interested in SPLR after seeing the dramatic reduction in spasticity and the improvement in function in my patients who had undergone the procedure. Since observations of improvement up to this point had been subjective, I decided to measure and document the physical status of patients before and after surgery. Twenty-nine patients who underwent Selective Posterior Lumbar Rhizotomy in 1985 were studied. In order to be as objective as possible, crawling and gait analyses were done in addition. All the patients were assessed clinically two days prior to surgery and then between four and fourteen months after surgery. For both preoperative and postoperative assessments, resistance to passive movement, degree of joint stiffness, ability to initiate and inhibit voluntary movement, and the degree of abnormal function in the developmental positions (rolling, sitting, kneeling, crawling, standing and walking) were graded on rating scales. Analyses of gait and crawling were done using a digital camera system. Results of the study indicated that SPLR produced a statistically significant reduction in muscle tone and in joint stiffness. Improvements in voluntary movement and functional movement (rolling, sitting, kneeling, crawling, standing and walking) were also statistically significant. It was concluded that Selective Posterior Lumbar Rhizotomy is a useful method of reducing spasticity and results in improvement of the quality of life in patients with spastic cerebral palsy. 2017-10-27T06:34:38Z 2017-10-27T06:34:38Z 1988 2017-04-21T14:11:06Z Master Thesis Masters MSc (Med) http://hdl.handle.net/11427/25839 eng application/pdf Division of Occupational Therapy Faculty of Health Sciences University of Cape Town |
| spellingShingle | Spasticity - Surgery Nerves, Spinal - Roots - Surgery Occupational Therapy Berman, Barbara Assessment of spastic patients before and after selective posterior lumbar rhizotomy |
| thesis_degree_str | Master's |
| title | Assessment of spastic patients before and after selective posterior lumbar rhizotomy |
| title_full | Assessment of spastic patients before and after selective posterior lumbar rhizotomy |
| title_fullStr | Assessment of spastic patients before and after selective posterior lumbar rhizotomy |
| title_full_unstemmed | Assessment of spastic patients before and after selective posterior lumbar rhizotomy |
| title_short | Assessment of spastic patients before and after selective posterior lumbar rhizotomy |
| title_sort | assessment of spastic patients before and after selective posterior lumbar rhizotomy |
| topic | Spasticity - Surgery Nerves, Spinal - Roots - Surgery Occupational Therapy |
| url | http://hdl.handle.net/11427/25839 |
| work_keys_str_mv | AT bermanbarbara assessmentofspasticpatientsbeforeandafterselectiveposteriorlumbarrhizotomy |