Percutaneous Myofacial Lengthening

For most parents, their child’s overall quality of life, meaning their psychosocial and emotional well-being, is their paramount consideration when making health care decisions for their child.  When considering medical treatments or interventions, parents often want to know how it will improve their child’s overall quality of life, rather than simply looking at how it will improve their child’s function – especially when the proposed treatment or procedure involves medical risks, pain or discomfort, or a lengthy recovery period.  This, however, has not traditionally been the focus of research studies which often measure the effectiveness of a given medical treatment or procedure in relation to improvements in function or symptoms without necessarily considering whether any such improvements affect the child’s overall quality of life.

This recent study is unique in that it looks at whether a medical procedure, namely selective percutaneous myofascial lengthening, improves the child’s overall quality of life and psychosocial and emotional wellbeing.

Selective percutaneous myofascial lengthening is a minimally invasive surgery that aims to lengthen certain muscles and/or reduce tone (spasticity) in certain muscles. It is a day procedure, involving very small incisions and allowing immediate mobilization and full weight-bearing activities shortly therafter. It is combined with an active (rather than passive) functional strengthening physiotherapy program.

This recent study looked at how this medical procedure affects the overall quality of life of the children who undergo the procedure followed by the physiotherapy program. Research participants were children with spastic CP, aged 5-7 years, with Gross Motor Function Classification System levels II-IV.

The results of the study showed that children undergoing percutaneous myofascial lengthening followed by a 9-month physiotherapy program showed significantly improved quality of life scores, reflecting improved quality of life and well-being (lower levels of psychological distress, more positive self-feelings, greater self-esteem, higher self-concept, and greater self-confidence), which are important aspects of their participation in life.

This improvement in quality of life seems to be related to the positive effects of this intervention on gross motor function in children with spastic cerebral palsy as gross motor function has been shown to be a closely related to quality of life in school-aged children with spastic cerebral palsy.

This research study provided further support for the benefits of percutaneous myofascial lengthening and we commend the authors of this study for broadening their scope of investigation to include factors beyond function and symptoms and focus on the child’s psychosocial and emotional wellbeing as well.  We encourage any parent interested in gaining a better understanding of whether this medical intervention would be beneficial for their child to speak with their child’s healthcare provider for medical advice.