{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T00:11:52Z","timestamp":1790381512622,"version":"4.1.0"},"reference-count":20,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2018,2,8]],"date-time":"2018-02-08T00:00:00Z","timestamp":1518048000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"VZW Move To Improve"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Develop Med Child Neuro"],"published-print":{"date-parts":[[2018,5]]},"abstract":"<jats:sec><jats:title>Aim<\/jats:title><jats:p>To explore the evolution of self\u2010care and functional mobility after multilevel surgery in children and adolescents with spastic diplegic cerebral palsy and to identify factors affecting these outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>Thirty\u2010four participants (22 males, 12 females) were evaluated before surgery, and at 2 months, 6 months, 1 year, 18 months, and 2 years after surgery. Self\u2010care was assessed with the Pediatric Evaluation of Disability Inventory Dutch edition. The Mobility Questionnaire47 (MobQues47) and Functional Mobility Scale (FMS) were used to measure functional mobility.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>All outcomes revealed a significant decrease 2 months after single\u2010event multilevel surgery (SEMLS) (<jats:italic>p<\/jats:italic>\u2010value between &lt;0.001 and 0.02) followed by a significant increase at 6 months (<jats:italic>p<\/jats:italic>&lt;0.001 and <jats:italic>p<\/jats:italic>=0.045). Between 6 months and 1 year, a significant increase was also revealed for Mobques47 (<jats:italic>p<\/jats:italic>&lt;0.001), FMS (<jats:italic>p<\/jats:italic>\u22640.008), and the Pediatric Evaluation of Disability Inventory Functional Skills Scale (PEDI\u2010FSS) (<jats:italic>p<\/jats:italic>=0.001). Improvement continued until 18 months for the PEDI\u2010FSS. Initial score, initial muscle strength, Gross Motor Function Classification System level, age, and number of surgical interventions significantly influenced time trends for self\u2010care and\/or functional mobility.<\/jats:p><\/jats:sec><jats:sec><jats:title>Interpretation<\/jats:title><jats:p>Most preoperative scores are regained at 6 months after SEMLS. Further improvement is seen until 18 months. Participants with a higher functional level before surgery will temporarily lose more than participants with lower initial functional ability, but they also fast regain their function.<\/jats:p><\/jats:sec><jats:sec><jats:title>What this paper adds<\/jats:title><jats:p>\n<jats:list list-type=\"bullet\">\n\n<jats:list-item><jats:p>Self\u2010care and functional mobility decrease significantly in the first months after single\u2010event multilevel surgery (SEMLS).<\/jats:p><\/jats:list-item>\n\n<jats:list-item><jats:p>Six months after SEMLS most preoperative scores are regained.<\/jats:p><\/jats:list-item>\n\n<jats:list-item><jats:p>Impact of SEMLS is more pronounced for functional mobility than for self\u2010care.<\/jats:p><\/jats:list-item>\n\n<jats:list-item><jats:p>Muscle strength and functionality at baseline are important influencing factors on the evolution after SEMLS.<\/jats:p><\/jats:list-item>\n<\/jats:list>\n<\/jats:p><\/jats:sec>","DOI":"10.1111\/dmcn.13683","type":"journal-article","created":{"date-parts":[[2018,2,8]],"date-time":"2018-02-08T07:06:39Z","timestamp":1518073599000},"page":"505-512","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":30,"title":["Evolution of self\u2010care and functional mobility after single\u2010event multilevel surgery in children and adolescents with spastic diplegic cerebral palsy"],"prefix":"10.1111","volume":"60","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8640-6962","authenticated-orcid":false,"given":"Griet","family":"Dequeker","sequence":"first","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation University Hospitals Leuven KU Leuven Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8158-5535","authenticated-orcid":false,"given":"Anja","family":"Van Campenhout","sequence":"additional","affiliation":[{"name":"Department of Development and Regeneration University Hospitals Leuven KU Leuven Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hilde","family":"Feys","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Sciences KU Leuven Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guy","family":"Molenaers","sequence":"additional","affiliation":[{"name":"Department of Development and Regeneration University Hospitals Leuven KU Leuven Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,2,8]]},"reference":[{"key":"e_1_2_8_2_1","first-page":"S13","article-title":"Treatment of spastic diplegia in patients with cerebral palsy: part II","volume":"13","author":"Aiona MD","year":"2004","journal-title":"J Pediatr Orthop B"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-8749.2011.04143.x"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gaitpost.2012.05.022"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.2340\/16501977-0916"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/BPO.0b013e3180dca147"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/BPO.0b013e3181c11c0c"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/BPO.0b013e3181da855f"},{"key":"e_1_2_8_9_1","first-page":"1","article-title":"Results of single\u2010event multilevel orthopedic surgery in children with cerebral palsy","volume":"2","author":"Tomov A","year":"2015","journal-title":"Adv Pediatr Res"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-8749.2010.03729.x"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-8749.2009.03341.x"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.apmr.2003.05.009"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.98B2.35959"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-8749.2011.03995.x"},{"key":"e_1_2_8_15_1","volume-title":"Handleiding PEDI\u2010NL","author":"Wassenberg\u2010Severijnen J","year":"2005"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-8749.2007.00603.x"},{"key":"e_1_2_8_17_1","volume-title":"Daniels and Worthingham's Muscle Testing: Techniques of Manual Examination","author":"Hislop H","year":"2007"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ridd.2010.09.025"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.J.00410"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-8749.2001.tb00755.x"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-8749.2008.03196.x"}],"container-title":["Developmental Medicine &amp; 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