Hip displacement and overall function in severe cerebral palsy

Issue title: Hip Disease in Cerebral Palsy

Article type: Research Article

Authors: Zarrinkalam, R. | Rice, J.^; | Brook, P. | Russo, R.N.^;

Affiliations: The Department of Paediatric Rehabilitation, Women's and Children's Health Network, Women's and Children's Hospital Campus, North Adelaide, SA, Australia | Flinders School of Medicine, Flinders University, Bedford Park, SA, Australia | The Department of Orthopaedic Surgery, Women's and Children's Health Network, Women's and Children's Hospital Campus, North Adelaide, SA, Australia

Note: [] Corresponding author: Rosa Zarrinkalam (MD, FRACP), Paediatric Rehabilitation Fellow, The Department of Paediatric Rehabilitation, Women's and Children's Health Network, Women's and Children's Hospital Campus, King William Road, North Adelaide, Adelaide, SA 5006, Australia. Tel.: +61 8 8161 7367; Fax: +61 8 8161 8488; E-mail: rosa.zarrinkalam@health.sa.gov.au

Abstract: Objective: The aim of this study was to investigate the relationship between hip displacement (HD) in individuals with severe cerebral palsy with function and quality of life (QOL). The second aim was to identify differences in these outcomes when comparing surgical and non-surgical management for HD. Design: Cross-sectional study of 26 participants born between 1988 and 1998 who had hip displacement on their most recent hip radiograph. Method: Caregivers completed the Caregiver Priorities and Child Health Index of Life with Disabilities (CPCHILD©) questionnaire. Hip migration percentage and a validated hip classification were used. Results: Significant positive correlation coefficients (CC) were found for mobility and comfort (CC=0.620, ρ = 0.001) as well as for QOL and comfort (CC=0.683, ρ < 0.001). Orthopedic hip surgery was associated with better scores for mobility (median [95% CI]); surgery vs. none; (36.1 [27.7, 44.4]) vs (25.6 [22.2, 29.8]) and personal care, (32.1 [27.1, 43.2]) vs (25.9 [22.7, 30.8]). Severity of HD had no significant association with comfort or QOL. Conclusion: Mobility and personal care scores were significantly better in children who had undergone reconstructive hip surgery. However, QOL and pain scores were not associated with the severity of hip displacement or undertaking reconstructive hip surgery.

Keywords: Cerebral palsy, child, hip displacement, quality of life

DOI: 10.3233/PRM-2011-0175

Journal: Journal of Pediatric Rehabilitation Medicine, vol. 4, no. 3, pp. 197-203, 2011