Functional outcomes following surgery for spastic hip adductor muscles in ambulatory and non-ambulatory adults.
Daphnée Brun, Olivier Hamel, Emmeline Montané and 6 others
PMID 38528325WHAT IT FOUND
Seventeen of 22 adults who had obturator nerve surgery for spastic hip adductor muscles were responders for their main patient-defined goal at follow-up.
Objective walking results varied, and no control group means the surgery cannot be proven to cause the gains.
Key findings
01Most patients achieved their main patient-set goal: 17 of 22 were responders, and 14 of 23 achieved all of their goals.
02Response rates were similar for ambulatory and non-ambulatory goals (65% vs 74%), and the difference was not significant.
03Objective walking outcomes varied: among 12 patients with pre- and post-3D gait analysis, walking speed decreased in half and step width increased beyond 2 standard deviations in 3.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
No control group or comparison treatment, so outcomes cannot be separated from disease progression, ageing, weight gain, rehabilitation, botulinum toxin, other surgeries or medication changes. The population was small and heterogeneous, so subgroups could not be examined. The study was retrospective; preoperative data were gathered from reports, and oral spasticity medication changes were not recorded. Follow-up was variable and often long, with a median of 29 months and some intervals exceeding 6 years, during which disease progression, ageing, weight gain and other treatments could affect results. Goal Attainment Scaling was imperfect: for most patients only score 0 was defined before surgery, and score +2 was chosen after surgery. Walking perimeter was collected subjectively, without objective recording such as a 6-minute walk test. 3D gait analysis frontal-plane hip rotation data were unreliable because of measurement error and poorly defined knee flexion-extension axes.
Declared interests
The authors declared no financial conflict of interest. Toulouse University Hospital paid the open-access fees.
The easy way to misread this
Do not read the 77% main-goal response as proof that surgery works. This was an uncontrolled observational study, patients also received rehabilitation, botulinum toxin and other treatments, oral medication changes were not recorded, and objective walking results varied.