Level of Improvement Determined by PODCI is Related to Parental Satisfaction After Single-event Multilevel Surgery in Children With Cerebral Palsy

Abstract

Background: This study was performed to determine changes in Pediatric Outcomes Data Collection Instrument (PODCI) scores after single-event multilevel surgery (SEMS), and to evaluate the relationship between the improvements of PODCI scores and parental satisfaction after SEMS. Methods: Demographic data, preoperative and postoperative PODCI, functional assessment questionnaire (FAQ) walking scales, and self-reported parental satisfaction with SEMS were obtained from 61 parents of ambulatory patients with cerebral palsy [40 male, 21 female, mean age 10 y 2mo (SD 3 y 8 mo), mean follow-up 2 y 2 mo]. Postoperative improvements in each subscale of PODCI and FAQ were analyzed, and multiple regression analysis was performed to identify the factors that contributed significantly to postoperative parental satisfaction. Rasch analysis was performed for the PODCI subscale that was clinically relevant. Results: FAQ, transfers/basic mobility, sports/physical activity, and global function subscales of PODCI significantly improved after SEMS. Age, gross motor function classification system level, and the amount of improvement in sports/physical activity subscale were found to affect parental satisfaction to SEMS significantly. However, the subscale showed insufficient item responses, and ceiling and floor effects. Conclusions: Although changes in sports/physical activity subscale were relatively small, they were found to affect parental satisfaction with SEMS significantly. These indicate that clinicians and researchers should pay attention to sports and physical activities in patients with cerebral palsy.