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   18-Feb-2025
 

Arch Hellen Med, 42(2), March-April 2025, 188-195

ORIGINAL PAPER

Selective percutaneous myofascial lengthening and functional physiotherapy in cerebral palsy
Parental perceptions and experiences

V.C. Skoutelis,1,2,3 Z. Dimitriadis,4 A.D. Kanellopoulos,5 A. Dinopoulos,1,6 P.J. Papagelopoulos,1,7 V. Kanellopoulos,8 V.A. Kontogeorgakos1,7
1Medical School, National and Kapodistrian University of Athens, Athens
2Laboratory of Neuromuscular and Cardiovascular Study of Motion, Department of Physiotherapy, School of Health and Caring Sciences, University of West Attica, Egaleo, Attica
3Department of Physiotherapy, "Attikon" University General Hospital, Chaidari, Attica
4Research Laboratory of Health and Quality of Life, Department of Physiotherapy, School of Health Sciences, University of Thessaly, Lamia
5Orthopedic Centre, "IASO" Children's Hospital, Maroussi, Attica
6Third Department of Pediatrics, "Attikon" University General Hospital, Chaidari, Attica
7First Department of Orthopedic Surgery, "Attikon" University General Hospital, Chaidari, Attica, Greece
8Boston University Graduate Medical Sciences, Boston, Massachusetts, USA

OBJECTIVE To explore the perceptions and experiences of parents of children with cerebral palsy (CP), regarding a combined programme of functional physiotherapy and minimally invasive orthopedic surgery, based on the selective percutaneous myofascial lengthening (SPML) surgery.

METHOD This study was a qualitative research based on thematic analysis. Data were collected using semi-structured interviews with 10 parents of operated children with spastic CP (Gross Motor Function Classification System levels II-IV) after completion of the SPML surgery and 9 months of postoperative physiotherapy. Interviews were conducted either at participants' own home or via telephone depending on participant preference.

RESULTS Five themes were identified: (a) Issues affecting parental decision-making for orthopedic surgery; (b) preoperative anxiety and postoperative pain; (c) necessity of the intervention; (d) differentiation of postoperative physiotherapy rehabilitation from usual physiotherapy treatment; and (e) parent-reported effectiveness of the intervention.

CONCLUSIONS According to the parents' opinions, the SPML surgery was a necessary and effective solution to optimize the motor performance of their children with CP. The parents acknowledged the important role of postoperative functional physiotherapy in achieving the functional outcome. The cost, the general anesthesia, as well as the negative attitudes of other specialized health professionals against this orthopedic surgical method, were the issues that concerned the parents before surgery.

Key words: Cerebral palsy, Functional physiotherapy, Interview, Parents, Qualitative research, Selective percutaneous myofascial lengthening.

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