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news News Monday, January 6, 2020 Monday, January 6, 2020 11:24 AM - Monday, January 6, 2020 11:24 AM

Spokane Shriners Hospital collaborates in multi-hospital research project

Spokane Shriners Hospital collaborates in multi-hospital research project

The Spokane Shriners Hospital has collaborated with the Salt Lake City Shriners Hospital and Minnesota’s Gillette Children’s Specialty Healthcare in a multi-hospital research project: Comparing the effects of two spasticity management strategies on the long-term outcomes of individuals with bilateral spastic cerebral palsy: a multicentre cohort study protocol. The group analyzed the long-term outcomes of a highly-interventional versus a minimally-interventional spasticity management treatment plan for patients living with cerebral palsy (CP).

Spasticity is defined as “a condition in which certain muscles have overactive or over-responsive reflexes.” This reflex activity may cause jerky movements, muscle tightness or joint stiffness, and can interfere with normal movement, speech and gait. Spasticity is one of the primary conditions associated with CP, yet no specific evidence exists to guide the appropriate level of spasticity management treatment plans for patients.

Spasticity management strategies often differ by center. At one end of this treatment spectrum is a highly-interventional approach which could include surgery, such as a selective dorsal rhizotomy (SDR) and anti-spasticity injections and medications. At the other end of the spectrum is a less interventional approach involving minimal use of these treatments and no surgery.

Eighty individuals will be involved in the research; 20 at the Spokane Shriners Hospital, 20 at the Salt Lake City Shriners Hospital and 40 at Gillette Children’s. Each hospital asked adults over 21 years old with spastic bilateral CP to return to the motion analysis center (MAC) for a walking study. The participants had been seen in the MAC when they were children between 4 and 10 years of age. They measured 3-D walking quality, energy consumption, gross motor functions such as getting up to stand or walking up and down stairs, and quality of life.

In one group are the individuals who had surgery for an SDR between the ages of 4 and 10 years, along with ongoing spasticity management such as injections and medications during childhood and adolescence. In the other group are individuals who received minimal spasticity management and did not undergo an SDR surgery.

Research activity is now being completed at all organizations and results are being analyzed to produce the outcome of the project. A study such as this one, with multiple hospitals from multiple health care systems, has the potential to guide future treatment of spasticity for the patients we see with cerebral palsy.