naa a22 4500 528786237 20180924065500.0 cr unu---uuuuu 180924e20130726xx s 000 0 eng 10.3929/ethz-b-000070607 doi 10.1371/journal.pone.0069500 doi (ETHRESEARCH)oai:www.research-collection.ethz.ch:20.500.11850/70607 Temporal but Not Spatial Variability during Gait Is Reduced after Selective Dorsal Rhizotomy in Children with Cerebral Palsy [Elektronische Daten] [Mustafa Sinan Bakir, Franziska Gruschke, William R. Taylor, Ernst Johannes Haberl, Ilya Sharankou, Carsten Perka, Julia F. Funk] PLoS ONE Open access ethresearch Introduction Variability in task output is a ubiquitous characteristic that results from non-continuous motor neuron firing during muscular force generation. However, variability can also be attributed to errors in control and coordination of the motor neurons themselves in diseases such as cerebral palsy (CP). Selective dorsal rhizotomy (SDR), a neurosurgical approach to sever sensory nerve roots, is thought to decrease redundant or excessive afferent signalling to intramedullary neurons. In addition to its demonstrated ability to reduce muscular spasticity, we hypothesised that SDR is able to decrease variability during gait, the most frequent functional motor activity of daily living. Methods Twelve CP children (aged 6.1±1.3yrs), who underwent SDR and performed gait analysis pre- and 12 months postoperatively, were compared to a control group of eleven typically developing (TD) children. Coefficients of variability as well as mean values were analysed for: temporal variables of gait, spatial parameters and velocity. Results Gait parameters of cadence (p = 0.006) and foot progression angle at mid-stance (p = 0.041) changed significantly from pre- to post-SDR. The variability of every temporal parameter was significantly reduced after SDR (p = 0.003-0.049), while it remained generally unchanged for the spatial parameters. Only a small change in gait velocity was observed, but variability in cadence was significantly reduced after SDR (p = 0.015). Almost all parameters changed with a tendency towards normal, but differences between TD and CP children remained in all parameters. Discussion The results confirm that SDR improves functional gait performance in children with CP. However, almost exclusively, parameters of temporal variability were significantly improved, leading to the conjecture that temporal variability and spatial variability may be governed independently by the motor cortex. As a result, temporal parameters of task performance may be more vulnerable to disruption, but also more responsive to treatment success of interventions such as SDR. Creative Commons Attribution 3.0 Unported http://creativecommons.org/licenses/by/3.0 ethresearch Bakir Mustafa Sinan joint author Gruschke Franziska joint author Taylor William R. joint author Haberl Ernst Johannes joint author Sharankou Ilya joint author Perka Carsten joint author Funk Julia F. joint author PLoS ONE Public Library of Science 8 (7), p. e69500 1932-6203 http://hdl.handle.net/20.500.11850/70607 text/html WWW-Backlink auf das Repository (Open access) 1 Journal Article ethresearch ETHRESEARCH 856 40 http://hdl.handle.net/20.500.11850/70607 text/html WWW-Backlink auf das Repository (Open access) ETHRESEARCH 700 1- Bakir Mustafa Sinan joint author ETHRESEARCH 700 1- Gruschke Franziska joint author ETHRESEARCH 700 1- Taylor William R. joint author ETHRESEARCH 700 1- Haberl Ernst Johannes joint author ETHRESEARCH 700 1- Sharankou Ilya joint author ETHRESEARCH 700 1- Perka Carsten joint author ETHRESEARCH 700 1- Funk Julia F. joint author ETHRESEARCH 773 0- PLoS ONE Public Library of Science 8 (7), p. e69500 1932-6203 BK010053 XK010053 XK010000 ETHRESEARCH ETHRESEARCH ETHRESEARCH Journal Article Open access