{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,7]],"date-time":"2026-01-07T14:40:29Z","timestamp":1767796829580,"version":"3.49.0"},"reference-count":56,"publisher":"BMJ","issue":"12","license":[{"start":{"date-parts":[[2025,12,8]],"date-time":"2025-12-08T00:00:00Z","timestamp":1765152000000},"content-version":"unspecified","delay-in-days":7,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000272","name":"National Institute for Health and Care Research","doi-asserted-by":"publisher","award":["NIHR 302916"],"award-info":[{"award-number":["NIHR 302916"]}],"id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000272","name":"National Institute for Health and Care Research","doi-asserted-by":"publisher","award":["NIHR 303636"],"award-info":[{"award-number":["NIHR 303636"]}],"id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2025,10,28]]},"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Selective dorsal rhizotomy (SDR) is one of the treatment options available for spasticity management in ambulatory children and young people with cerebral palsy (CYPwCP). Although improvements in gross motor function one to two years after surgery have been established, evidence of longer-term benefit requires further investigation. Given the irreversible nature of SDR and the increased rehabilitation commitments required from families and clinicians, providing evidence of longer-term benefits is essential to support their decision-making. This study aims to investigate medium (3\u20135 years) and long-term (6\u201310 years) SDR outcomes in ambulatory children with CP and how SDR affects families\u2019 lives over time.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>This is a convergent parallel mixed-methods study using the International Classification of Functioning, Disability and Health as a theoretical framework. The study aims to recruit 90 CYPwCP participants, who had SDR at a tertiary hospital in the UK when aged between 3 and 14 years. Participants (parents and CYPwCP) will be invited to complete an online survey and attend the hospital for one follow-up visit 3 or more years after SDR. Comparisons will be made with existing data on objective measures and parent-reported outcomes collected in clinical practice at baseline, 6, 12 and 24 months to understand the trajectory of changes. Semistructured interviews will be conducted with 18\u201320 parents\/carers and 25\u201330 CYPwCP to understand their perspectives on the outcomes of SDR compared with their prior expectations. The Framework Method will be used to analyse qualitative data both inductively and deductively. Qualitative and quantitative study data will be integrated using joint displays.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>Ethical approval has been obtained through the Coventry and Warwick Research and Ethics Committee (24\/WM\/0078). Findings will be shared through international conferences, peer-reviewed journals, social media and dissemination events for families and CYP.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration number<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"clintrialgov\" xlink:href=\"NCT06518889\">NCT06518889<\/jats:ext-link>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2025-108558","type":"journal-article","created":{"date-parts":[[2025,12,9]],"date-time":"2025-12-09T09:09:26Z","timestamp":1765271366000},"page":"e108558","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Mixed-methods study exploring medium to longer-term outcomes following selective dorsal rhizotomy in ambulatory children w\n                    <b>i<\/b>\n                    th cerebral palsy at a tertiary hospital in the UK: MOSAiC study protocol"],"prefix":"10.1136","volume":"15","clinical-trial-number":[{"clinical-trial-number":"nct06518889","registry":"10.18810\/clinical-trials-gov"},{"clinical-trial-number":"nct06518889","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1002-0334","authenticated-orcid":false,"given":"Deepti","family":"Chugh","sequence":"first","affiliation":[{"name":"Physiotherapy, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK"},{"name":"Physiotherapy, III, University College London Great Ormond Street Institute of Child Health, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2045-1883","authenticated-orcid":false,"given":"Cherry","family":"Kilbride","sequence":"additional","affiliation":[{"name":"Health Sciences, Brunel University London, Uxbridge, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hortensia","family":"Gimeno","sequence":"additional","affiliation":[{"name":"Queen Mary University of London, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kristian","family":"Aquilina","sequence":"additional","affiliation":[{"name":"Neurosurgery, Great Ormond Street Hospital For Children NHS Foundation Trust, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lucy","family":"Alderson","sequence":"additional","affiliation":[{"name":"Physiotheray, ORCHID, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tim","family":"Theologis","sequence":"additional","affiliation":[{"name":"Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, 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