Physical Therapy Management of a Pediatric Patient with Spastic Cerebral Palsy following a Selective Dorsal Rhizotomy: A Case Report

Background: Cerebral palsy is one of the most common childhood disorders, but there is controversial literature about the best treatment interventions to address the impairments associated with the condition. The purpose of this case report is to highlight physical therapy interventions to improve independent mobility in a child with cerebral palsy after the first 6 months following a selective dorsal rhizotomy. Case Description: A 6-year-old patient with spastic triplegic cerebral palsy who underwent a selective dorsal rhizotomy followed by intensive outpatient pediatric physical therapy is the focus of this report. Interventions included gait training with and without assistive devices, gait training and balance training in and outside of in body weight supporting devices, functional mobility with stairs, and other age-appropriate gross motor skills training. Outcomes: The patient completed 6 months of therapy and was able to ambulate 50 feet without an assistive device, maintain dynamic balance while performing an upper extremity task, and negotiate stairs with forearm crutches. Discussion: This case report describes the plan of care for a child diagnosed with cerebral palsy GMFCS level III who underwent a selective dorsal rhizotomy and highlights physical therapy interventions addressing independent mobility, activities of daily living, and participation in the community and at home. These functional outcomes following this surgical approach paired with physical therapy interventions may suggest that this approach is a successful treatment for individuals with spastic cerebral palsy.