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Knee cerebral palsy

Agnieszka Guzik, Mariusz Drużbicki, Andrzej Kwolek, Grzegorz Przysada, Katarzyna Bazarnik-Mucha, Magdalena Szczepanik, Andżelina Wolan-Nieroda, Marek Sobolewski
BACKGROUND: In clinical practice there is a need for a specific scale enabling detailed and multifactorial assessment of gait in children with spastic hemiplegic cerebral palsy. The practical value of the present study is linked with the attempts to find a new, affordable, easy-to-use tool for gait assessment in children with spastic hemiplegic cerebral palsy. The objective of the study is to evaluate the Wisconsin Gait Scale (WGS) in terms of its inter- and intra-rater reliability in observational assessment of walking in children with hemiplegic cerebral palsy...
September 15, 2018: BMC Pediatrics
Yusuke Endo, Hirotaka Mutsuzaki, Masafumi Mizukami, Kenichi Yoshikawa, Yasuto Kobayashi, Arito Yozu, Yuki Mataki, Shogo Nakagawa, Nobuaki Iwasaki, Masashi Yamazaki
[Purpose] The hybrid assistive limb was developed to improve the kinematics and muscle activity in patients with neurological and orthopedic conditions. The purpose of the present study was to examine the long-term sustained effect of gait training using a hybrid assistive limb on gait stability, kinematics, and muscle activity by preventing knee collapse in a patient with cerebral palsy. [Participant and Methods] A 17 year-old male with cerebral palsy performed gait training with a hybrid assistive limb 12 times in 4 weeks...
September 2018: Journal of Physical Therapy Science
Miray-Su Yılmaz Topçuoğlu, Britta K Krautwurst, Matthias Klotz, Thomas Dreher, Sebastian I Wolf
BACKGROUND: Walking on inclined surfaces is an everyday task, which challenges stability and propulsion even in healthy adults. Children with cerebral palsy adapt similarly to inclines like healthy children do. However, how stability and propulsion in these subjects are influenced by different inclines remained unaddressed as of yet. RESEARCH QUESTION: The aim was to examine the feeling of safety, stability and propulsion of children with cerebral palsy when walking on inclines to gain insight into the challenges they might face on these conditions...
August 28, 2018: Gait & Posture
Giuseppina Pilloni, Massimiliano Pau, Francesco Costici, Claudia Condoluci, Manuela Galli
BACKGROUND: In children with spastic Cerebral Palsy (CP), the treatment of equinus foot with Achilles tendon lengthening (ATL) surgery is associated with high incidence of overcorrection, which may result in crouch gait. AIM: We aimed to assess if gait pattern in preoperative time could be a predictor of the surgery outcome. DESIGN: Cross-sectional retrospective study. SETTING: Movement Analysis Lab, IRCCS San Raffaele Pisana Hospital, Rome (ITALY)...
August 27, 2018: European Journal of Physical and Rehabilitation Medicine
T Hastings-Ison, M Sangeux, P Thomason, B Rawicki, M Fahey, H K Graham
Purpose: Botulinum toxin-A (or Botox) is widely used for the management of equinus gait in children with cerebral palsy but few recent studies have included instrumented gait analysis. Methods: This was a prospective cohort study. Gait analysis was performed four weeks before and four weeks after Botulinum toxin-A injection for spastic equinus to detect the maximum effects on gait kinematics. Outcome measures included the Gait Profile Score (GPS), the Gait Variable Score (GVS) for the ankle, maximal ankle dorsiflexion and maximal knee extension at midstance...
August 1, 2018: Journal of Children's Orthopaedics
Andrew J Ries, Michael H Schwartz
AIM: To investigate any performance differences between the solid ankle-foot orthosis (SAFO) and ground reaction ankle-foot orthosis (GRAFO) designs for correcting crouch gait in children diagnosed with cerebral palsy (CP). METHOD: We retrospectively analyzed 147 individuals seen at our center who: (1) were diagnosed with diplegic CP, (2) walked with crouch gait, (3) had bilateral SAFO or GRAFO prescription, and (4) had three-dimensional gait analysis collected for both barefoot and orthosis walking conditions...
August 26, 2018: Developmental Medicine and Child Neurology
James J Carollo, Kate Worster, Zhaoxing Pan, Julie Ma, Frank Chang, Joanne Valvano
BACKGROUND: The purpose of this retrospective study was to explore lower limb intersegmental coordination as a clinically important indicator of motor control mechanisms in individuals with cerebral palsy exhibiting stiff-knee gait. We used the relative phase of thigh and foot segments around foot-off to describe motor control, given the relevance of the pre-swing phase of gait to the existence of stiff-knee gait. METHODS: Traditional gait parameters and thigh/foot intersegmental coordination were calculated using pre-and postoperative kinematic data from a cohort of 54 subjects (92 legs) with spastic cerebral palsy...
August 6, 2018: Clinical Biomechanics
In Soo Kim, Donghwi Park, Jin Young Ko, Ju Seok Ryu
OBJECTIVE: To evaluate whether medial knee support in seating systems aggravates hip displacement in children with cerebral palsy. DESIGN: Retrospective chart review SETTING: Rehabilitation department of tertiary university hospital PARTICIPANTS: Children with cerebral palsy using seating systems (Intervention group, n=42; mean age 6.86y) and using regular wheelchairs (Control group, n=34; mean age 8.15y). INTERVENTIONS: The intervention group was provided with a seating system with medial knee support...
August 10, 2018: Archives of Physical Medicine and Rehabilitation
Manuela Galli, Veronica Cimolin, Claudia Condoluci, Pier Francesco Costici, Reinald Brunner
Dynamic joint stiffness represents the resistance that a joint opposes to an applied moment. Stiffness arises in conditions of joint laxity, instability and increased co-contraction and is commonly utilized as a means to stabilize the joint. The knee joint seems to be crucial for determining the walking pattern. The aim of this study was to investigate the association between the gait pattern, globally quantified by the Gait Profile Score (GPS), which indicates the 'quality' of a particular walking strategy, and knee dynamic joint stiffness (Kk) in children with diplegia...
July 2018: Journal of Bodywork and Movement Therapies
Sarah J Holmes, Anita J Mudge, Elizabeth A Wojciechowski, Matthias W Axt, Joshua Burns
BACKGROUND: Children with cerebral palsy are at risk of developing muscle contractures, often contributing to pain, structural deformities and mobility limitations. With the increasing use of gait indices to summarise the findings of three dimensional gait analysis (3DGA), the purpose of this study is to determine whether there is a relationship between multilevel joint contractures and the Gait Profile Score in children with cerebral palsy. METHODS: The Gait Profile Score, calculated from 3D gait analysis, and passive range of motion, strength and spasticity of the hips, knees and ankles in the sagittal plane were measured in 145 children with cerebral palsy (mean age:11 years,4 months; SD:2 years,10 months) (83 males) enrolled in the NSW Paediatric Gait Analysis Service Research Registry from 2011 to 2016...
August 8, 2018: Clinical Biomechanics
Ingrid Skaaret, Harald Steen, Terje Terjesen, Inger Holm
BACKGROUND: Different types of ankle-foot orthoses are commonly used following lower limb surgery in children with bilateral spastic cerebral palsy. After three-dimensional gait analysis 1 year postoperatively, many children are recommended continued use of ankle-foot orthoses. OBJECTIVES: Our aims were to quantify the impact of ankle-foot orthoses on gait 1 year postoperatively and evaluate predictors for clinically important improvement. STUDY DESIGN: Prospective cohort study...
August 7, 2018: Prosthetics and Orthotics International
Hans Kainz, Marije Goudriaan, Antoine Falisse, Catherine Huenaerts, Kaat Desloovere, Friedl De Groote, Ilse Jonkers
BACKGROUND: Musculoskeletal models do not include patient-specific muscle forces but rely on a scaled generic model, with muscle forces left unscaled in most cases. However, to use musculoskeletal simulations to inform clinical decision-making in children with cerebral palsy (CP), inclusion of subject-specific muscle forces is of utmost importance in order to represent each child's compensation mechanisms introduced through muscle weakness. RESEARCH AIM: The aims of this study were to (i) evaluate if maximum isometric muscle forces (MIMF) in musculoskeletal models of children with CP can be scaled based on strength measurements obtained with a hand-held-dynamometer (HHD), (ii) evaluate the impact of the HHD based scaling approach and previously published MIMF scaling methods on computed muscle forces during gait, and (iii) compare maximum muscle forces during gait between CP and typically developing (TD) children...
September 2018: Gait & Posture
Anna Mirska, Wojciech Kułak, Bożena Okurowska-Zawada, Elżbieta Dmitruk
PURPOSE: The aim of this study was to assess the effectiveness of long-term therapy with multiply botulinum neurotoxin (BoNT) injections. METHODS: In 2004-2010, 60 children with spastic cerebral palsy aged 2-16 were treated multiple botulinum toxin sessions (injections in gastrocnemius muscle and soleus muscles). In each patient, we rated muscle tone by Modified Ashworth Scale, passive range of motion in ankle joint with extended, and flexed knee joint and gait using the Physician Rating Scale...
July 30, 2018: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
Matthias Hösl, Harald Böhm, Justine Eck, Leonhard Döderlein, Adamantios Arampatzis
BACKGROUND: Patients with spastic Cerebral Palsy are prone to equinus deformities, likely affected by short and inextensible plantarflexor muscles. Manual stretching is a popular treatment but its effectiveness concerning joint mobility, muscle-tendon morphometrics and walking function is debated. Eccentric exercise by backward-downhill treadmill training could be a therapeutic alternative for ambulatory patients improving gait and muscle function. RESEARCH QUESTION: What are the effects of eccentric training by backward-downhill treadmill training and plantarflexor stretching concerning gait and muscle function in patients with spastic Cerebral Palsy? METHODS: 10 independent ambulators with spastic Cerebral Palsy (12 [SD 4] years old, 2 uni- and 8 bilaterally affected) participated in a randomized crossover-study...
September 2018: Gait & Posture
Chris A McGibbon, Andrew Sexton, Glen Hughes, Adam Wilson, Melony Jones, Colleen O'Connell, Kim Parker, Catherine Adans-Dester, Anne O'Brien, Paolo Bonato
OBJECTIVE: To evaluate a new portable toolkit for quantifying upper and lower extremity muscle tone in patients with upper motor neuron syndrome (UMNS). APPROACH: Cross-sectional, multi-site, observational trial to test and validate a new technology. SETTING: Neurorehabilitation clinics at tertiary care hospitals. PARTICIPANTS: Four cohorts UMNS patient, >6 mo post acquired brain injury, spinal cord injury, multiple sclerosis and cerebral palsy, and a sample of healthy age-matched adult controls...
August 8, 2018: Physiological Measurement
Atli Ágústsson, Thorarinn Sveinsson, Pauline Pope, Elisabet Rodby-Bousquet
OBJECTIVE: The aim of this study was to clarify the association of scoliosis and windswept hips with immobility, lying position, and time in lying, in adults with cerebral palsy (CP). METHODS: This cross-sectional study included 830 adults (469 males and 361 females) with a diagnosis of CP, 16-73 years, and classified at levels I-V according to the Gross Motor Function Classification System (GMFCS). Subjects' Gross motor function classification system level, presence and severity of scoliosis, hip and knee joint range of movement, lying position, postural ability in lying, and time in lying were used to identify connections between them...
July 16, 2018: Disability and Rehabilitation
Sun-Hye Jung, Sun-Hae Song, Sang-Duck Kim, Kyeongbong Lee, Gyu-Chang Lee
PURPOSE: The present study investigated the effects of virtual reality (VR) training using the Xbox Kinect on motor function, balance, gait, and functional mobility in children with cerebral palsy (CP). METHOD: This was a case series. Four children with spastic diplegic cerebral palsy were provided VR training using the Xbox Kinect for 12 sessions (three sessions per week for 4 weeks). At baseline and follow-up, physical function was measured using the following: Selective Motor Control (SMC) for motor function, Pediatric Balance Scale (PBS) for balance, Timed Up and Go (TUG) test and Functional Mobility Scale (FMS) for functional mobility, and 6-meter walk test (6WT) for gait...
2018: Journal of Pediatric Rehabilitation Medicine
Brunno L Moreira, Tasos Karakostas, Luciano S Dias
BACKGROUND: Rectus femoris transfer (RFT) is performed in children with cerebral palsy to treat stiff-knee gait. However, the results are variable in part because there is no gold standard to identify appropriate candidates. Hip flexion kinematics and kinetics are important factors in the determination of peak knee flexion during gait. This study aimed to evaluate whether a kinetic preoperative analysis of hip power can be a predictor of RFT outcomes and determine its usability for identifying appropriate candidates for the procedure...
October 2018: Journal of Pediatric Orthopedics
Lisa C Drefus, Siobhan Clarke, Karen Resnik, Jayme Koltsov, Emily R Dodwell, David M Scher
Background: Stiff-knee gait is a common gait deviation in individuals with cerebral palsy (CP) due to rectus femoris (RF) muscle spasticity. The Duncan-Ely test is a velocity-dependent measurement of spasticity that is recorded as positive or negative. At our institution, we use a modification of the Duncan-Ely test, a 5-point ordinal rating scale, which delineates where the catch occurs within the rapid arc of knee flexion. It has been named the Root-Ely test. Questions/Purposes: We sought to determine the intra- and inter-rater reliability of the Duncan-Ely and Root-Ely tests in pediatric patients with CP...
July 2018: HSS Journal: the Musculoskeletal Journal of Hospital for Special Surgery
Ja Young Choi, Eun Sook Park, Dongho Park, Dong-Wook Rha
BACKGROUND: Previous researchers reported that popliteal angle did not correlate well with knee angle during gait in individuals with spastic cerebral palsy (CP). RESEARCH QUESTION: To determine if hamstring spasticity, as measured by Modified Tardieu Scale (MTS) at rest, is associated with knee flexion angle at initial contact and midstance during gait. METHODS: Thirty ambulatory children (mean age 8.7 ± 2.4 years) diagnosed with spastic CP participated...
July 2018: Gait & Posture
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