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https://www.readbyqxmd.com/read/28279852/effectiveness-of-surgical-and-non-surgical-management-of-crouch-gait-in-cerebral-palsy-a-systematic-review
#1
REVIEW
Scott A Galey, Zachary F Lerner, Thomas C Bulea, Seymour Zimbler, Diane L Damiano
BACKGROUND: Cerebral palsy (CP) is a prevalent group of neuromotor disorders caused by early injury to brain regions or pathways that control movement. Patients with CP exhibit a range of functional motor disabilities and pathologic gait patterns. Crouch gait, characterized by increased knee flexion throughout stance, is a common gait pattern in CP that increases energy costs of walking and contributes to ambulatory decline. Our aim was to perform the first systematic literature review on the effectiveness of interventions utilized to ameliorate crouch gait in CP...
February 24, 2017: Gait & Posture
https://www.readbyqxmd.com/read/28278135/the-influence-of-the-unaffected-hip-on-gait-kinematics-in-patients-with-hemiplegic-cerebral-palsy
#2
Mikhail Tretiakov, Khanh P Do, Michael Aiona
BACKGROUND: Hemiplegic cerebral palsy (HCP) patients have transverse-plane gait deviations that may include the "uninvolved" side. The aim of this study is to quantify the static rotational profile, the dynamic position during gait and determine whether any correlations between the involved and uninvolved side exist. METHODS: A total of 171 subjects that met the inclusion criteria of HCP and no prior history of bony surgery were reviewed. Clinical and gait measurements were analyzed and compared between subjects and a population of typically developing (TD) children...
April 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28243195/part-2-adaptation-of-gait-kinematics-in-unilateral-cerebral-palsy-demonstrates-preserved-independent-neural-control-of-each-limb
#3
Thomas C Bulea, Christopher J Stanley, Diane L Damiano
Motor adaptation, or alteration of neural control in response to a perturbation, is a potential mechanism to facilitate motor learning for rehabilitation. Central nervous system deficits are known to affect locomotor adaptation; yet we demonstrated that similar to adults following stroke, children with unilateral brain injuries can adapt step length in response to unilateral leg weighting. Here, we extend our analysis to explore kinematic strategies underlying step length adaptation and utilize dynamical systems approaches to elucidate how neural control may differ in those with hemiplegic CP across legs and compared to typically developing controls...
2017: Frontiers in Human Neuroscience
https://www.readbyqxmd.com/read/28242571/predictors-for-anterior-pelvic-tilt-following-surgical-correction-of-flexed-knee-gait-including-patellar-tendon-shortening-in-children-with-cerebral-palsy
#4
Harald Böhm, Matthias Hösl, Leonhard Döderlein
INTRODUCTION: Patellar tendon shortening procedure within single event multilevel surgeries was shown to improve crouch gait in Cerebral Palsy (CP) patients. However, one of the drawbacks associated to the correction of flexed knee gait may be increased pelvic anterior tilt with compensatory lumbar lordosis. RESEARCH QUESTION: Which CP patients are at risk for excessive anterior pelvic tilt following correction of flexed knee gait including patellar tendon shortening? METHODS: 32 patients with CP between 8 and 18 years GMFCS I&II were included...
February 21, 2017: Gait & Posture
https://www.readbyqxmd.com/read/28226960/a-robotic-exoskeleton-to-treat-crouch-gait-from-cerebral-palsy-initial-kinematic-and-neuromuscular-evaluation
#5
Zachary F Lerner, Diane L Damiano, Thomas C Bulea, Zachary F Lerner, Diane L Damiano, Thomas C Bulea, Diane L Damiano, Zachary F Lerner, Thomas C Bulea
A robotic exoskeleton was designed for individuals with crouch gait caused by cerebral palsy with the intent to supplement existing muscle function during walking. The aim of this study was to evaluate how powered knee extension assistance provided during stance and swing phases of the gait cycle affect knee kinematics, and knee flexor and extensor muscle activity. Muscle activity and kinematic data were collected from four individuals with crouch gait from cerebral palsy during their normal walking condition and while walking with the exoskeleton under stance, swing, and stance & swing assistance...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28224608/inter-and-intrarater-clinician-agreement-on-joint-motion-patterns-during-gait-in-children-with-cerebral-palsy
#6
Angela Nieuwenhuys, Eirini Papageorgiou, Guy Molenaers, Davide Monari, Tinne de Laet, Kaat Desloovere
AIM: This study aimed to quantify the inter- and intrarater clinician agreement on joint motion patterns in children with spastic cerebral palsy (CP), which were recently specified by a Delphi consensus study. It also examined whether experience with three-dimensional gait analysis (3DGA) is a prerequisite for using the patterns. METHOD: The experimental group consisted of 82 patients with CP (57 males, 25 females; uni-/bilateral CP [n=27/55]; Gross Motor Function Classification System levels I to III; mean age 9y 5mo [range 4y-18y])...
February 22, 2017: Developmental Medicine and Child Neurology
https://www.readbyqxmd.com/read/28092566/wake-up-exoskeleton-to-assist-children-with-cerebral-palsy-design-and-preliminary-evaluation-in-level-walking
#7
Fabrizio Patane, Stefano Rossi, Fausto Del Sette, Juri Taborri, Paolo Cappa
This paper presents the modular design and control of a novel compliant lower limb multi-joint exoskeleton for the rehabilitation of ankle knee mobility and locomotion of pediatric patients with neurological diseases, such as Cerebral Palsy (CP). The device consists of an untethered powered knee-ankle-foot orthosis (KAFO), addressed as WAKE-up (Wearable Ankle Knee Exoskeleton), characterized by a position control and capable of operating synchronously and synergistically with the human musculoskeletal system...
January 11, 2017: IEEE Transactions on Neural Systems and Rehabilitation Engineering
https://www.readbyqxmd.com/read/28074440/distal-femoral-extension-and-shortening-osteotomy-as-a-part-of-multilevel-surgery-in-children-with-cerebral-palsy
#8
Matthias C M Klotz, Klemens Hirsch, Daniel Heitzmann, Michael W Maier, Sebastien Hagmann, Thomas Dreher
BACKGROUND: There are several reports describing an increase in anterior pelvic tilt after hamstring lengthening in children with cerebral palsy (CP). Distal femoral extension and shortening osteotomy (DFESO) is an alternative treatment for correction of fl exed knee gait, but investigations analyzing outcome and infl uence on adjacent joint are few in the literature. The purpose of this study was to analyze the influence of DFESO on knee and pelvis in children with CP. Furthermore, it was of interest if an additional patellar tendon advancement (PA) infl uences outcome...
December 23, 2016: World Journal of Pediatrics: WJP
https://www.readbyqxmd.com/read/28063935/effects-of-spinal-cord-stimulation-on-motor-functions-in-children-with-cerebral-palsy
#9
I A Solopova, I A Sukhotina, D S Zhvansky, G A Ikoeva, S V Vissarionov, A G Baindurashvili, V R Edgerton, Y P Gerasimenko, T R Moshonkina
Is it possible to regulate the functional properties of abnormally developed spinal neuronal locomotor networks using transcutaneous spinal cord stimulation? This question has been studied in twenty-eight participants (∼9 yrs) with spastic cerebral palsy, and mainly Gross Motor Function Classification System for Cerebral Palsy level III. The participants were randomly assigned to two groups. The experimental group received transcutaneous spinal cord stimulation at two spinal levels (over T11 and L1 spinous processes), combined with locomotor treadmill training, whereas the participants of the control group received locomotor treadmill training only...
February 3, 2017: Neuroscience Letters
https://www.readbyqxmd.com/read/28040656/squat-test-performance-and-execution-in-children-with-and-without-cerebral-palsy
#10
M M Eken, J Harlaar, A J Dallmeijer, E de Waard, C A M van Bennekom, H Houdijk
BACKGROUND: Knowledge on lower extremity strength is imperative to informed decision making for children with cerebral palsy (CP) with mobility problems. However, a functional and clinically feasible test is not available. We aimed to determine whether the squat test is suitable for this purpose by investigating test performance and execution in children with cerebral palsy and typically developing (TD) peers. METHODS: Squat test performance, defined by the number of two-legged squats until fatigue (max 20), was assessed in twenty children with bilateral CP (6-19years; gross motor function classification system I-III) and sixteen TD children (7-16years)...
January 2017: Clinical Biomechanics
https://www.readbyqxmd.com/read/28026724/-gait-analysis-in-patients-with-hip-disorders
#11
K Urbášek, J Poul
Recent studies have shown that the evaluation of both conservative and surgical therapy cannot do without gait analysis. Orthopaedic textbooks, with some exceptions, deal in great detail with a thorough clinical examination of the patient but gait assessment is mentioned only marginally. More attention is paid to gait analysis in rehabilitation medicine. Motion and gait analysis laboratories equipped with optoelectronic cameras and force platforms were first developed for cerebral palsy children. Recently, several studies have been published on the use of these methods in disorders of hip and knee joints or spine diseases...
2016: Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca
https://www.readbyqxmd.com/read/28009799/percutaneous-hamstring-lengthening-surgery-is-as-effective-as-open-lengthening-in-children-with-cerebral-palsy
#12
Alexander Nazareth, Susan Rethlefsen, Ted C Sousa, Nicole M Mueske, Tishya A L Wren, Robert M Kay
BACKGROUND: Surgical lengthening of the hamstrings is often performed to correct crouch gait in children with cerebral palsy (CP). Previous studies have demonstrated the effectiveness of open hamstring lengthening (oHSL) in improving knee extension static and dynamic range of motion; however, literature regarding percutaneous hamstring lengthening (pHSL) is limited. The purpose of this study was to investigate the effect of open versus pHSL for improving crouch gait and knee function in children with CP...
December 22, 2016: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/27939752/influence-of-patellar-position-on-the-knee-extensor-mechanism-in-normal-and-crouched-walking
#13
Rachel L Lenhart, Scott C E Brandon, Colin R Smith, Tom F Novacheck, Michael H Schwartz, Darryl G Thelen
Patella alta is common in cerebral palsy, especially in patients with crouch gait. Correction of patella alta has been advocated in the treatment of crouch, however the appropriate degree of correction and the implications for knee extensor function remain unclear. Therefore, the goal of this study was to assess the impact of patellar position on quadriceps and patellar tendon forces during normal and crouch gait. To this end, a lower extremity musculoskeletal model with a novel 12 degree of freedom knee joint was used to simulate normal gait in a healthy child, as well as mild (23 deg min knee flexion in stance), moderate (41 deg), and severe (67 deg) crouch gait in three children with cerebral palsy...
January 25, 2017: Journal of Biomechanics
https://www.readbyqxmd.com/read/27927029/measuring-wearing-time-of-knee-ankle-foot-orthoses-in-children-with-cerebral-palsy-comparison-of-parent-report-and-objective-measurement
#14
Josina C Maas, Annet J Dallmeijer, Bodil Y Oudshoorn, Eline A M Bolster, Peter A Huijing, Richard T Jaspers, Jules G Becher
Purpose state: Orthotic wearing time may be an important confounder in efficacy studies of treatment in children with spastic cerebral palsy (SCP). Most studies measure parent-reported wearing time (WTparent) with questionnaires, but it is questionable whether this yields valid results. This study aims to compare WTparent with objectively measured wearing time (WTobj) in children with SCP receiving orthotic treatment. METHOD: Eight children with SCP participated in this observational study...
December 7, 2016: Disability and Rehabilitation
https://www.readbyqxmd.com/read/27883988/real-time-feedback-to-improve-gait-in-children-with-cerebral-palsy
#15
Linda van Gelder, Adam T C Booth, Ingrid van de Port, Annemieke I Buizer, Jaap Harlaar, Marjolein M van der Krogt
Real-time feedback may be useful for enhancing information gained from clinical gait analysis of children with cerebral palsy (CP). It may also be effective in functional gait training, however, it is not known if children with CP can adapt gait in response to real-time feedback of kinematic parameters. Sixteen children with cerebral palsy (age 6-16; GMFCS I-III), walking with a flexed-knee gait pattern, walked on an instrumented treadmill with virtual reality in three conditions: regular walking without feedback (NF), feedback on hip angle (FH) and feedback on knee angle (FK)...
November 11, 2016: Gait & Posture
https://www.readbyqxmd.com/read/27790051/astym-therapy-improves-bilateral-hamstring-flexibility-and-achilles-tendinopathy-in-a-child-with-cerebral-palsy-a-retrospective-case-report
#16
Nicole A Scheer, Lucas R Alstat, Robert S Van Zant
PURPOSE: The purpose of this case report was to describe the use of Astym therapy to improve hamstring flexibility and Achilles tendinopathy in a child with cerebral palsy. CASE DESCRIPTION: An eight-year-old female with cerebral palsy was referred to physical therapy for the treatment of bilateral hamstring inflexibility and Achilles tendinopathy. Treatment focused on an Astym therapy protocol of eccentric exercise, stretching, active and passive range of motion, gait training, and a home exercise program...
2016: Clinical Medicine Insights. Case Reports
https://www.readbyqxmd.com/read/27766077/no-decrease-in-muscle-strength-after-botulinum-neurotoxin-a-injection-in-children-with-cerebral-palsy
#17
Meta N Eek, Kate Himmelmann
Spasticity and muscle weakness is common in children with cerebral palsy (CP). Spasticity can be treated with botulinum neurotoxin-A (BoNT-A), but this drug has also been reported to induce muscle weakness. Our purpose was to describe the effect on muscle strength in the lower extremities after BoNT-A injections in children with CP. A secondary aim was to relate the effect of BoNT-A to gait pattern and range of motion. Twenty children with spastic CP were included in the study, 8 girls and 12 boys (mean age 7...
2016: Frontiers in Human Neuroscience
https://www.readbyqxmd.com/read/27755599/a-systematic-review-of-the-effects-of-single-event-multilevel-surgery-on-gait-parameters-in-children-with-spastic-cerebral-palsy
#18
Robert P Lamberts, Marlette Burger, Jacques du Toit, Nelleke G Langerak
BACKGROUND: Three-dimensional gait analysis (3DGA) is commonly used to assess the effect of orthopedic single-event multilevel surgery (SEMLS) in children with spastic cerebral palsy (CP). PURPOSE: The purpose of this systematic review is to provide an overview of different orthopedic SEMLS interventions and their effects on 3DGA parameters in children with spastic CP. METHODS: A comprehensive literature search within six databases revealed 648 records, from which 89 articles were selected for the full-text review and 24 articles (50 studies) included for systematic review...
2016: PloS One
https://www.readbyqxmd.com/read/27633845/predictive-factors-for-inpatient-falls-among-children-with-cerebral-palsy
#19
Ebru Alemdaroğlu, Sibel Demir Özbudak, Sibel Mandiroğlu, Seda Alakoç Biçer, Neşe Özgirgin, Halil Uçan
Inpatient falls are of significant concern. The aim of this prospective study was to determine the predictors of inpatient falls among children with cerebral palsy in a rehabilitation hospital. DESIGN AND METHODS: A total of 93 patients with cerebral palsy were assessed based on history, physical findings, the Selective Motor Control Test, the Gross Motor Functional Classification System, the Berg Balance Scale and the Manual Ability Classification System. Previous history of falls/frequent falls, and any falls which occurred during hospitalization, were recorded...
September 12, 2016: Journal of Pediatric Nursing
https://www.readbyqxmd.com/read/27613590/gastrocnemius-operating-length-with-ankle-foot-orthoses-in-cerebral-palsy
#20
Hwan Choi, Tishya Anne Leong Wren, Katherine Muterspaugh Steele
BACKGROUND: Many individuals with cerebral palsy wear ankle foot orthoses during daily life. Orthoses influence joint motion, but how they impact muscle remains unclear. In particular, the gastrocnemius is commonly stiff in cerebral palsy. Understanding whether orthoses stretch or shorten this muscle during daily life may inform orthosis design and rehabilitation. OBJECTIVES: This study investigated the impact of different ankle foot orthoses on gastrocnemius operating length during walking in children with cerebral palsy...
September 9, 2016: Prosthetics and Orthotics International
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