Post Selective Dorsal Rhizotomy Surgery - Ben

Objective

Rehabilitation following Selective Dorsal Rhizotomy (SDR), an operation used to improve spasticity (muscle stiffness) and mobility in cerebral palsy.

Background

Ben, then aged 9, was accepted for SDR spinal surgery on the NHS and went through two years of pre-op tests and scans, including an hour long MRI under general anaesthetic. One week before the date of the operation, Ben's family received the devastating news that it had been cancelled due to lack of funding and would no longer be available on the NHS.

The family raised the money for the operation, after which they discovered that, because they had self-funded, they were also liable for Ben's physiotherapy and aftercare. Our team saw Ben's story in the media and donated hydrotherapy sessions that would play a part in helping him to walk without pain.

Programme

  • Duration: 30 minutes
  • Water Temperature: 31˚C
  • Speed: Week 1 – 0.3kph / Week 24 – 3.3kph
  • Distance: Week 1 – 0.563km / Week 24 – 1.3km
  • Depth: 900mm
  • Resistance Jets: Not activated
  • Direction: Forwards
  • Number of Sessions: 24

Outcomes

The SDR procedure was only the start, as prolonged physiotherapy and training were needed, to build muscle, stretch tendons and retrain Ben's walking pattern.

Ben's programme started at a low speed of 0.3kph, with the water-level at 900mm to give him plenty of support whilst building up his strength and confidence. Exercises included hamstring stretches, heel push-downs and knee to chest leg raises. In the water, he was able to exercise pain-free and push himself without the risk of a fall or injury.

Later in his programme, Ben was encouraged to let go of the handrails, to include arm swing and work on a natural walking motion. This not only intensified the exercise but forced Ben to really concentrate on his walking pattern. The treadmill speed was also increased to up to 3.3kph for extended periods during the sessions, which, in the beginning, resulted in his heels coming back up and him needing to hold onto the handrails. By week 24, Ben was able to walk at the higher speed, hands-free and keeping his heels firmly down.

With the goal of walking unaided from his home, across the park, to his nan's house fixed in his mind, Ben, now aged 12, has shown nothing but sheer determination and hard work in the underwater treadmill. He thoroughly enjoys the sessions and his progress has been tremendous. As he continues to build strength, improve balance and gain more confidence, he is getting closer to achieving his goal and more.

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