Assessment of spastic patients before and after selective posterior lumbar rhizotomy

dc.contributor.advisorVaughan, Christopher Leonard (Kit)en_ZA
dc.contributor.authorBerman, Barbaraen_ZA
dc.date.accessioned2017-10-27T06:34:38Z
dc.date.available2017-10-27T06:34:38Z
dc.date.issued1988en_ZA
dc.date.updated2017-04-21T14:11:06Z
dc.description.abstractFor 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.en_ZA
dc.identifier.apacitationBerman, B. (1988). <i>Assessment of spastic patients before and after selective posterior lumbar rhizotomy</i>. (Thesis). University of Cape Town ,Faculty of Health Sciences ,Division of Occupational Therapy. Retrieved from http://hdl.handle.net/11427/25839en_ZA
dc.identifier.chicagocitationBerman, Barbara. <i>"Assessment of spastic patients before and after selective posterior lumbar rhizotomy."</i> Thesis., University of Cape Town ,Faculty of Health Sciences ,Division of Occupational Therapy, 1988. http://hdl.handle.net/11427/25839en_ZA
dc.identifier.citationBerman, B. 1988. Assessment of spastic patients before and after selective posterior lumbar rhizotomy. University of Cape Town.en_ZA
dc.identifier.ris TY - Thesis / Dissertation AU - Berman, Barbara AB - 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. DA - 1988 DB - OpenUCT DP - University of Cape Town LK - https://open.uct.ac.za PB - University of Cape Town PY - 1988 T1 - Assessment of spastic patients before and after selective posterior lumbar rhizotomy TI - Assessment of spastic patients before and after selective posterior lumbar rhizotomy UR - http://hdl.handle.net/11427/25839 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/25839
dc.identifier.vancouvercitationBerman B. Assessment of spastic patients before and after selective posterior lumbar rhizotomy. [Thesis]. University of Cape Town ,Faculty of Health Sciences ,Division of Occupational Therapy, 1988 [cited yyyy month dd]. Available from: http://hdl.handle.net/11427/25839en_ZA
dc.language.isoengen_ZA
dc.publisher.departmentDivision of Occupational Therapyen_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.subject.otherSpasticity - Surgeryen_ZA
dc.subject.otherNerves, Spinal - Roots - Surgeryen_ZA
dc.subject.otherOccupational Therapyen_ZA
dc.titleAssessment of spastic patients before and after selective posterior lumbar rhizotomyen_ZA
dc.typeMaster Thesis
dc.type.qualificationlevelMasters
dc.type.qualificationnameMSc (Med)en_ZA
uct.type.filetype
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceThesisen_ZA
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