{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T06:33:26Z","timestamp":1793428406391,"version":"4.5.0"},"reference-count":19,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,12]]},"abstract":"\n \n \n This prospective longitudinal observational study characterized 3-year functional mobility and health-related quality-of-life trajectories following single-event multilevel soft-tissue surgery in 32 children with spastic diplegic cerebral palsy, Gross Motor Function Classification System levels II\u2013IV. Functional Mobility Scale (FMS) scores at 5, 50, and 500\u2005m and parent-proxy Pediatric Quality of Life Inventory (PedsQL) Cerebral Palsy Module scores were assessed preoperatively and at 3, 6, 9 months, 1 year, and 3 years. FMS varied over time at all distances (Friedman\n P<\/jats:italic>\n \u2005<\u20050.001). Median 5-m and 50-m FMS fell from 4.5 preoperatively to 2.0 at 3 months and returned to 4.5 by 3 years; baseline-to-3-year shifts were favorable (5\u2005m: Bonferroni-adjusted\n P<\/jats:italic>\n \u2005=\u20050.0087,\n r<\/jats:italic>\n \u2005=\u20050.608; 50\u2005m: adjusted\n P<\/jats:italic>\n \u2005=\u20050.0158,\n r<\/jats:italic>\n \u2005=\u20050.579). At 500\u2005m, the median increased from 0 to 4.5 (adjusted\n P<\/jats:italic>\n \u2005=\u20050.0191,\n r<\/jats:italic>\n \u2005=\u20050.570), while N (does not apply; distance not completed) decreased from 19\/32 to 8\/32; 4.5 is an interpolated median between categories 4 and 5. Mean PedsQL increased from 68.2\u2005\u00b1\u200514.7 to 74.3\u2005\u00b1\u200514.5 (change +6.13, 95% confidence interval\u2005=\u20054.30\u20137.96;\n P<\/jats:italic>\n \u2005<\u20050.001) without early decline. No FMS distance changed significantly from 1 to 3 years. Short- and intermediate-distance mobility showed early deterioration followed by recovery to baseline medians, whereas community mobility and caregiver-reported quality of life showed favorable long-term shifts. These observational changes cannot be attributed solely to surgery.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1097\/mrr.0000000000000723","type":"journal-article","created":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T07:00:09Z","timestamp":1790578809000},"page":"271-277","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Trajectory of functional recovery and health-related quality of life following multilevel soft-tissue surgery in children with spastic diplegic cerebral palsy: a prospective longitudinal observational study"],"prefix":"10.1097","volume":"49","author":[{"given":"Vishal","family":"Sharma","sequence":"first","affiliation":[{"name":"Department of Orthopaedics, Max Healthcare, Bathinda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bobby","family":"John","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Christian Medical College and Hospital, Ludhiana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Max K.","family":"Shibu","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Christian Medical College and Hospital, Ludhiana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Navpreet","family":"Singh","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Sangrur Medicity Hospital, Sangrur, Punjab, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,10,27]]},"reference":[{"key":"R1-20261031","doi-asserted-by":"crossref","first-page":"15082","DOI":"10.1038\/nrdp.2015.82","article-title":"Cerebral palsy.","volume":"2","author":"Graham","year":"2016","journal-title":"Nat Rev Dis Primers"},{"key":"R2-20261031","doi-asserted-by":"crossref","first-page":"700","DOI":"10.1111\/dmcn.16274","article-title":"Proposed updated description of cerebral palsy.","volume":"67","author":"Dan","year":"2025","journal-title":"Dev Med Child Neurol"},{"key":"R3-20261031","doi-asserted-by":"crossref","first-page":"1492","DOI":"10.1152\/japplphysiol.00278.2018","article-title":"Muscle contracture and passive mechanics in cerebral palsy.","volume":"126","author":"Lieber","year":"2019","journal-title":"J Appl Physiol (1985)"},{"key":"R4-20261031","doi-asserted-by":"crossref","first-page":"2625","DOI":"10.1113\/jphysiol.2010.203364","article-title":"Hamstring contractures in children with spastic cerebral palsy result from a stiffer extracellular matrix and increased in vivo sarcomere length.","volume":"589","author":"Smith","year":"2011","journal-title":"J Physiol"},{"key":"R5-20261031","doi-asserted-by":"crossref","first-page":"554","DOI":"10.1111\/dmcn.14320","article-title":"Long-term effects of selective dorsal rhizotomy in children with cerebral palsy: a systematic review.","volume":"62","author":"Tedroff","year":"2020","journal-title":"Dev Med Child Neurol"},{"key":"R6-20261031","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1007\/s11832-010-0268-4","article-title":"Surgical correction of equinus deformity in children with cerebral palsy: a systematic review.","volume":"4","author":"Shore","year":"2010","journal-title":"J Child Orthop"},{"key":"R7-20261031","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1111\/j.1469-8749.2011.04143.x","article-title":"Single-event multilevel surgery for children with cerebral palsy: a systematic review.","volume":"54","author":"McGinley","year":"2012","journal-title":"Dev Med Child Neurol"},{"key":"R8-20261031","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1016\/j.gaitpost.2012.05.022","article-title":"Single Event Multilevel Surgery in children with bilateral spastic cerebral palsy: a 5 year prospective cohort study.","volume":"37","author":"Thomason","year":"2013","journal-title":"Gait Posture"},{"key":"R9-20261031","doi-asserted-by":"crossref","first-page":"514","DOI":"10.1097\/01241398-200409000-00011","article-title":"The Functional Mobility Scale.","volume":"24","author":"Graham","year":"2004","journal-title":"J Pediatr Orthop"},{"key":"R10-20261031","doi-asserted-by":"crossref","first-page":"603","DOI":"10.1111\/j.1469-8749.2007.00603.x","article-title":"The Functional Mobility Scale: ability to detect change following single-event multilevel surgery.","volume":"49","author":"Harvey","year":"2007","journal-title":"Dev Med Child Neurol"},{"key":"R11-20261031","doi-asserted-by":"crossref","first-page":"442","DOI":"10.1017\/S001216220600096X","article-title":"The PedsQL in pediatric cerebral palsy: reliability, validity, and sensitivity of the Generic Core Scales and Cerebral Palsy Module.","volume":"48","author":"Varni","year":"2006","journal-title":"Dev Med Child Neurol"},{"key":"R12-20261031","doi-asserted-by":"crossref","first-page":"e296","DOI":"10.1371\/journal.pmed.0040296","article-title":"The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies.","volume":"4","author":"von Elm","year":"2007","journal-title":"PLoS Med"},{"key":"R13-20261031","doi-asserted-by":"crossref","first-page":"214","DOI":"10.1111\/j.1469-8749.1997.tb07414.x","article-title":"Development and reliability of a system to classify gross motor function in children with cerebral palsy.","volume":"39","author":"Palisano","year":"1997","journal-title":"Dev Med Child Neurol"},{"key":"R14-20261031","doi-asserted-by":"crossref","first-page":"744","DOI":"10.1111\/j.1469-8749.2008.03089.x","article-title":"Content validity of the expanded and revised Gross Motor Function Classification System.","volume":"50","author":"Palisano","year":"2008","journal-title":"Dev Med Child Neurol"},{"key":"R15-20261031","doi-asserted-by":"crossref","first-page":"2040622319854241","DOI":"10.1177\/2040622319854241","article-title":"Physical therapy treatment in children with cerebral palsy after single-event multilevel surgery: a qualitative systematic review. A first step towards a clinical guideline for physical therapy after single-event multilevel surgery.","volume":"10","author":"van Bommel","year":"2019","journal-title":"Ther Adv Chronic Dis"},{"key":"R16-20261031","doi-asserted-by":"crossref","first-page":"88","DOI":"10.1111\/dmcn.13618","article-title":"Long-term development of gait after multilevel surgery in children with cerebral palsy: a multicentre cohort study.","volume":"60","author":"Dreher","year":"2018","journal-title":"Dev Med Child Neurol"},{"key":"R17-20261031","doi-asserted-by":"crossref","first-page":"2131","DOI":"10.1007\/s00402-021-03797-0","article-title":"Long-term follow-up after multilevel surgery in cerebral palsy.","volume":"142","author":"Visscher","year":"2022","journal-title":"Arch Orthop Trauma Surg"},{"key":"R18-20261031","doi-asserted-by":"crossref","first-page":"918","DOI":"10.1111\/j.1469-8749.2008.03150.x","article-title":"Outcome tools used for ambulatory children with cerebral palsy: responsiveness and minimum clinically important differences.","volume":"50","author":"Oeffinger","year":"2008","journal-title":"Dev Med Child Neurol"},{"key":"R19-20261031","doi-asserted-by":"crossref","first-page":"1201","DOI":"10.1111\/dmcn.13981","article-title":"Predictors affecting outcome after single-event multilevel surgery in children with cerebral palsy: a systematic review.","volume":"60","author":"Edwards","year":"2018","journal-title":"Dev Med Child Neurol"}],"container-title":["International Journal of Rehabilitation Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.1097\/MRR.0000000000000723","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T06:00:58Z","timestamp":1793426458000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.1097\/MRR.0000000000000723"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,27]]},"references-count":19,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.1097\/mrr.0000000000000723","relation":{},"ISSN":["0342-5282","1473-5660"],"issn-type":[{"value":"0342-5282","type":"print"},{"value":"1473-5660","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,27]]},"assertion":[{"value":"2026-05-25","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-13","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}