Review began 02/16/2021 Review ended 02/22/2021 Published 03/07/2021 © Copyright 2021 Gillani et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 4.0., which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Effectiveness of Treatment in Children With Cerebral Palsy Syed Faraz Ul Hassan Shah Gillani , Akkad Rafique , Muhammad Taqi , Muhammad Ayaz ul Haq Chatta , Faisal Masood , Tauseef Ahmad Blouch , Syed Muhammad Awais 1. Orthopedic Surgery, King Edward Medical University/Mayo Hospital Lahore, Lahore, PAK 2. Orthopedics and Traumatology, Mohterma Benazir Bhutto Medical Shaheed College, Mirpur Azad Jammu Kashmir, PAK 3. Orthopedics and Traumatology, King Edward Medical University/Mayo Hospital Lahore, Lahore, PAK 4. Surgery, King Edward Medical University/Mayo Hospital Lahore, Lahore, PAK 5. Orthopaedic Surgery, King Edward Medical University/Mayo Hospital Lahore, Lahore, PAK Corresponding author: Muhammad Taqi, dr.taqi227@yahoo.com Abstract Objective: The objective of this study was to assess the effectiveness of conservative and surgical treatment in cerebral palsy children by evaluating the Medical Research Council (MRC) grading system, modified Ashworth scale, and Barthel Activities of Daily Life (ADL) scale. Method: This prospective case series was performed using a non-probability consecutive sampling technique at the Department of Orthopedic Surgery and Traumatology, King Edward Medical University/Mayo Hospital, Lahore from October 2011 to November 2013. Two hundred children of all ages, having cerebral palsy diagnosed on history and clinical examination were enrolled in the study. Children were treated with conservative and surgical treatment. Pre- and post-treatment, all children were classified based on movement disorder (spastic, athetoid, ataxic, and mixed), parts of the body involved (paraplegic, tetraplegic, diplegic, hemiplegic, monoplegic, double hemiplegic, and triplegic), and gross motor function (GMFCS level I-IV). Their muscle power and tone were assessed using the MRC grading system and modified Ashworth scale, respectively. Assessment of disability and daily function was done by ranking disability grading and Barthel ADL, respectively. The range of motion (ROM) of each joint was assessed clinically. Children were divided based on the treatment method as non-surgical versus surgical treatment. Results: Out of a total of 200 children, the mean age of the children was 7.86±4.17year. There were 134 (67.0%) males and 66 (33.0%) female children. Classification on basis of movement disorder, body part involved, and gross motor function at three-month intervals till twelve months was performed. From the first presentation of children till the last follow-up time period, i.e., 12th month there was no change in the movement disorder (a type of CP, body parts involved, and GMFCS). The final rating of overall treatment results shows that there were 84 (42%) patients who had a poor outcome, and only 35 (17.50%) patients had a fair treatment outcome and 81 (40.50%) patients had good treatment outcomes. Conclusion: The conservative and surgical management showed no effect on movement disorder of the child although, on the final rating scale fair to good treatment outcome was observed in all children. There was an improvement in muscle power grading on the ADL, but no significant improvement was seen on the improvement of type, parts of the body involved, gross motor function classification, modified Ashworth, and ranking disability grading of the children. Categories: Neurology, Pediatrics, Orthopedics Keywords: cerebral palsy, congenital disease, central nervous system, motor impairment syndrome, gait analysis Introduction Cerebral palsy (CP) is a group of non-progressive disorders of the brain and nervous system dysfunction. It affects the child's movement, vision, learning, and thinking processes [1]. It can occur before birth, during birth, and within the first year of childbirth [2]. It appears as a result of brain injuries and abnormalities that can present two years after birth. In some children, it occurs as a result of brain hypoxia while premature infants have a higher risk of developing CP [3,4]. The reported incidence of CP is 1.5 to 2.5 per 1000 childbirth. These incidences were higher between 1960 and 1980. Now, data have reported 0.5 per 1000 childbirths [5]. Diplegic CP has a 95% survival rate versus 75% in quadriplegic children till the age of 30 years. Survival of mild to severe mental retard rate has been reported as 65% and 90%, respectively, till the age of 38 years with an overall survival rate is 90% till the age of 20 years [6]. CP is the second most common disease after mental retardation that causes disability in child growth, but it also affects adults. There is a lack of special training amongst primary healthcare physicians and specialists 1 2 3 4 5 3 3 Open Access Original Article DOI: 10.7759/cureus.13754 How to cite this article Gillani S, Rafique A, Taqi M, et al. (March 07, 2021) Effectiveness of Treatment in Children With Cerebral Palsy. Cureus 13(3): e13754. DOI 10.7759/cureus.13754