ASSESSMENT OF UPPER-EXTREMITY FUNCTION IN CHILDREN WITH SPASTIC DIPLEGIA BEFORE AND AFTER SELECTIVE DORSAL RHIZOTOMY

The upper-extremity function of 26 children (mean age 6.0 years) with spastic diplegia was assessed prior to and one year following selectiv e dorsal rhizotomy (SDR). No significant change was found in upper ext remity range of motion, muscle tone, or strength (MMT). A significant increase was noted in grasp strength bilaterally which could not be ex plained simply on the basis of maturation, Manipulation patterns were noted to improve significantly one year after SDR; however, this was p roposed to be a maturation rather than intervention effect, Standardiz ed test results revealed no significant improvement in functional hand use when the scores of children with spastic diplegia were compared w ith age-matched norms, to control for the effect of maturation, The si gnificant improvement found in ability to toilet, dress and undress in dependently was most likely due to the effect of SDR on lower-extremit y muscle tone. Further investigation with a matched control group woul d provide a conclusive result regarding the effect of SDR on upper ext remity function and assist in understanding the maturation of hand fun ction in children with spastic diplegia.