SDR (Selective Dorsal Rhizotomy)

SDR  (spinal dorsal Rhizotomy) is a surgical procedure where nerve roots are cut in the spine to reduce spasticity for children who have Cerebral Palsy.  This operation has recently been approved for children in the UK who fit certain criteria.

The procedure uncovers a lot of weakness, previously masked by spasticity, in the child’s trunk and legs.  Following the procedure children are required to undergo intensive physiotherapy for the following 5 years, and in particular for the first year.  Most centres recommend physiotherapy at least 3 times per week for the first 6 months.  Rehabilitation is typically focused on strengthening these weaker muscles that have not been able to contract due to the spasticity.

It is often recommended that children have physiotherapy prior to their referral to their nearest SDR centre in order to build up stability and strength in order to maximise the effect of the surgery.

As more and more children undergo SDR surgery, we have become increasingly aware for the need for high quality specialist physiotherapy prior and following surgery. Our highly specialist physiotherapists have broad experience of treating children with Cerebral Palsy.  We have seen the success and unlocked potential that intensive physiotherapy offers.  Our sessions are always focused on the child, using their interests to engage them in play activities, making physiotherapy fun and engaging.

At Heel and Toe, we offer both weekly sessions, and intensive therapy blocks aimed at building strength and stability for children prior and following SDR surgery. The physiotherapist will liaise with you to set goals that are both achievable and specific to your child.  Our physiotherapists are experienced at breaking down goals into smaller chunks to make them achievable, as well as progressing goals at appropriate times to make sure children are achieving the best of their potential.

Our block therapy provides a great opportunity to really dig deep and focus on achievable goals in order to progress children quicker, or to help progress to the next step when children get ’stuck’.

Goals of physiotherapy include:

Strengthening muscle

Re education of normal movement patterns

Managing spasticity and pain

Advice on exercises and appropriate progression when it is indicated

Gait training using facilitation techniques and treadmill training

Research shows that good results following SDR surgery were directly linked with intensive and long term physiotherapy. This can have significant cost implications on the wider family.  We are able to offer a ‘pot’ for all children attending paid services at Heel and Toe.  This is a way that facilitates fundraising efforts in order to help the family pay for their child’s therapy.  Please contact us if you would like more information.

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