The Road to Recovery After Selective Dorsal Rhizotomy

Cerebral palsy is a condition that describes children who had a brain injury at or around the time of birth. Children with cerebral palsy often have increased spasticity. Spasticity means there is an abnormal muscle response to stretch. When someone has spasticity, the muscle tenses up when it is stretched quickly. The increased tension can contribute to toe walking, reduced balance, increased effort to move limbs and pain.

What Is Selective Dorsal Rhizotomy?

Selective dorsal rhizotomy (SDR) is a neurosurgical procedure where some of the sensory nerves in the back (nerves that help you feel your legs) are cut to decrease spasticity (tension) in the legs. Children with cerebral palsy often learn to walk and balance with spasticity. When the spasticity is reduced through this surgery, their legs move and feel different. This leads to an initial decline in their ability to walk and move. Although children initially have more difficulty with motor skills after the surgery, it also gives the child a period where their body is more ready to make changes. We call this “neuroplasticity.”

Physical Therapy: What To Expect After Surgery?

During the period after surgery where change may occur faster, coming to therapy more often is important. This allows the child to relearn the skills they had before surgery and, in some cases, helps them learn new skills they couldn’t do prior to surgery. Physical therapy may be recommended up to 5 times per week after surgery. The exact amount of physical therapy recommended depends on how your child moved before surgery, how they move after surgery, and the goals of the surgery. Children with disabilities require consistent, sometimes daily practice to improve their movement skills, just like someone training for a marathon. Therefore, it is important that the family practice these skills at home too.

Treatment provided by a physical therapist following SDR should address the specific strength and functional needs of your child. Exercises that will be most beneficial are determined by the child’s specific abilities. However, research suggests there are some common requirements to make changes in motor skills. They include:

• 30-45 minutes of daily practice
• The child should practice the specific skills they want to improve.
• The child must be able to try the skill themselves. Therapy doesn’t work if the therapist or caregiver is doing all the work for the child.
• Allowing for errors when practicing a skill. Making mistakes is an important part of learning.

What Can Parents Do?

Parents can support recovery at home by:

• Completing any home exercises prescribed by their PT
• Looking for local community activities their child can participate in
• Maintaining an active lifestyle. Taking a walk in the park, climbing up hills and crawling through tunnels are great ways to improve strength and performance while having fun!