Lower extremity sensory function in children with cerebral palsy.

OBJECTIVES

(1) To determine the feasibility of qualitative sensory testing in the lower extremities (LE) of children with cerebral palsy (CP), especially spastic diplegia. (2) To determine if there is a detectable difference in qualitative LE sensory function in children with CP compared to typical children. (3) To determine if dorsal rhizotomy results in detectable changes in LE sensory function in children with spastic diplegia.

DESIGN

Objectives 1 and 2: Prospective observational cohort study. Objective 3: Add-on to prospective interventional studies.

SETTING

Regional tertiary children's hospital.

PARTICIPANTS

Objectives 1 and 2: 62 children with CP and 65 typical children between 3-18 years of age. Objective 3: 34 children with spastic diplegia.

INTERVENTIONS: Objectives 1 and 2: None. Objective 3: Dorsal rhizotomy.

MAIN OUTCOME MEASURES: Pain, light touch, direction of scratch, vibration, toe position and knee position using standard qualitative techniques.

RESULTS

Objective 1: 32 (52%) children with CP and 55 (85%) typical children completed all items (p = 0.09). Objective 2: Summary scores for separate LE sensory modalities were lower in children with CP for direction of scratch (p < 0.001), toe position (p = 0.01) and vibration sense (p = 0.01). Objective 3: No changes of LE sensory function.

CONCLUSIONS

LE sensory testing in young children with CP is feasible. There is a qualitative sensory deficit in this sample of children with CP and specifically in children with spastic diplegia that is traditionally associated with dorsal column sensory modalities. A conservative dorsal rhizotomy does not produce a measurable change in LE sensory function in this sample of children with spastic diplegia.