Influence of gait analysis on decision-marketing for lower extremity surgery

Parents’ satisfaction after single stage multilevel surgery in ambulatory children with cerebral palsy

CY CHUNG MD, M S PARK MD, I H CHOI MD, T J CHO MD,
W J YOO MD

  1. 1. Seoul National University Bundang Hospital, Kyungki, Korea

Objectives: To determine the factors affecting parents’ satisfaction after single stage multilevel surgery in ambulatory children with cerebral palsy(CP)>

Design: A case series study.

Setting: Tertiary referral centre.

Participants: Two hundred and seventy-one ambulatory patients with cerebral palsy, Gross Motor Function Classification System (GMFCS) Levels I to III, were evaluated. There were 160 patients with diplegia and 111 with hemiplegia. All patients underwent single stage multilevel surgery and were followed over 1 year. Age at surgery averaged 8 years 8 months (SD 5y6mo).

Materials/Methods: Parents’ satisfaction with surgery was evaluated by visual analogue scale (10-scaled). GMFCS level and preoperative Gillette Functional Assessment Questionnaire (FAQ) walking scale were reviewed and postoperative Pediatric Outcomes Data Collection Instrument (PODCI) and FAQ were obtained via postal survey. Mean follow-up was 5 years 6 months. Patients were divided into two groups: a satisfied group (visual analogue scale (VAS) >_7) and an unsatisfied group (VAS<_6). Each comparison was carried out using non-parametric tests with significance level set at p<_0.05.

Results: Mean patients’ satisfaction was 7.8 (median 8). There were 213 satisfied parents and 58 unsatisfied. FAQ scale improved significantly in both groups (Table SP:32a). Patients of GMFCS Level I were more satisfied than those of Levels II or III (p<0.01, Table SP:32b). Patients with hemiplegia were more satisfied with surgical outcome than those with diplegia (p<0.01) while the FAQ scale was less increased in patients with hemiplegia (mean 9.2-9.6 in hemiplegia, 7.1-8.3 in diplegia). In five domains of PODCI (all, p<0.01), except the upper extremity domain (p=11), the satisfied group showed significantly better scores.

Conclusions: Patients with less severe involvement show better satisfaction. The possible reasons for this are cosmetic problem, elimination of social stigma, or patients’ expectation, which is too high in severely involved patients. We can use these data when we explain the expected outcome and satisfaction of the surgery

 
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