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Knee cerebral palsy

Adriana Neves Dos Santos, Nelci Adriana Cicuto Ferreira Rocha
BACKGROUND: Kinesiotaping (KT) has been commonly used in clinical setting. However, beneficial KT effects have not been proved yet. OBJECTIVE: We aimed to verify the effects of KT in knee extensor torque in children with CP. METHODS: We evaluated three children diagnosed as spastic CP, classified as level I, II and III, according with GMFCS. Knee extensor peak torque was analyzed by isokinetic evaluation (Biodex Multi Joint System). The test was performed at 60°/s in the concentric passive mode and the children performed maximal contractions...
November 8, 2018: NeuroRehabilitation
Vasileios C Skoutelis, Anastasios Kanellopoulos, Stamatis Vrettos, Georgios Gkrimas, Vasileios Kontogeorgakos
BACKGROUND: Selective Percutaneous Myofascial lengthening (SPML) is an innovative minimally invasive surgical procedure, using micro incisions often combined with alcohol nerve block, for managing muscle contractures and stiffness in children with cerebral palsy (CP). There is lack of evidence of effects of a combined intervention of SPML and physiotherapy on gait function and muscle strength in CP. OBJECTIVE: This study investigated the change in gait function and muscle strength in children with CP who underwent gait laboratory assessment before and after SPML, combined with obturator nerve blocks, and 9-month post-surgical functional physiotherapy...
November 2, 2018: NeuroRehabilitation
Gregor Kuntze, Alberto Nettel-Aguirre, Gina Ursulak, Ion Robu, Nicole Bowal, Simon Goldstein, Carolyn A Emery
BACKGROUND: Clinical management of children and youth with cerebral palsy (CP) is increasingly supported by computerized gait analysis. Methods have been developed to reduce the complexity of interpreting biomechanical data and quantify meaningful movement patterns. However, few methods are inclusive of multiple joints and planes of motion, and consider the entire duration of gait phases; potentially limiting insight into this heterogeneous pathology. The objective of this study was to assess the implementation of k-means clustering to determine clusters of participants with CP based on multi-joint gait kinematics...
2018: PloS One
Nicole M Mueske, Sylvia Õunpuu, Deirdre D Ryan, Bitte S Healy, Jeffrey Thomson, Paul Choi, Tishya A L Wren
BACKGROUND: Gait analysis provides quantitative data that can be used to supplement standard clinical evaluation in identifying and understanding gait problems. It has been established that gait analysis changes treatment decision making for children with cerebral palsy, but this has not yet been studied in other diagnoses such as spina bifida. RESEARCH QUESTION: To determine the effects of gait analysis data on pathology identification and surgical recommendations in children with spina bifida...
October 9, 2018: Gait & Posture
Kemble K Wang, Jean L Stout, Andrew J Ries, Tom F Novacheck
AIM: To assess interobserver reliability in the interpretation of three-dimensional gait analysis (3DGA) of children with gait disorders within a single institution. METHOD: Seven experienced interpreters in our institution participated in a quality-assurance program reviewing one unique patient's 3DGA data every 3 months. Between 2014 and 2017, 15 patients' data were interpreted (14 with spastic cerebral palsy, 1 with myelodysplasia). Interpreters were asked to select 'yes', 'no', or 'indeterminate' from a list of problems and treatment recommendations...
October 15, 2018: Developmental Medicine and Child Neurology
L Abbasi, Z Rojhani-Shirazi, M Razeghi, H Raeisi Shahraki
Background: Deficits in upper body movement have received little attention during gait in cerebral palsy (CP) children with crouch gait pattern (CGP). Objective: Purpose of this research is to describe the correlation of trunk movement with the excessive knee flexion and ankle kinematic in CP children with CGP. Material and Methods: Gait analysis data from 57 limbs of diplegic CP children with CGP and 26 limbs of normal children was gathered...
September 2018: Journal of Biomedical Physics & Engineering
Rafael Krätschmer, Harald Böhm, Leonhard Döderlein
BACKGROUND: Classification of sagittal gait patterns in unilateral spastic cerebral palsy (CP) provides direct implication for treatment. Five types are described: type 0 has minor gait deviation; type 1 has inadequate ankle dorsiflexion in swing; type 2 has inadequate ankle dorsiflexion throughout the gait cycle; types 3 and 4 have abnormal function of the knee and hip joint respectively. During gait analysis of children with unilateral spastic CP we observed frequently that a knee flexion deficit disappeared during running...
October 3, 2018: Gait & Posture
Duangporn Suriyaamarit, Sujitra Boonyong
BACKGROUND: Sit-to-stand (STS) is one of the most common fundamental activity in daily life. The pathology of the neuromuscular control system in children with spastic diplegic cerebral palsy (SDCP) could contribute to atypical movement patterns leading to the inefficiency performance including the STS task. However, there was also a lack of evidence about kinematics, kinetics, and especially mechanical work during the STS task in children with SDCP aged 7-12 years old. RESEARCH QUESTION: What were the differences in mechanical work, kinematics and kinetics during STS task between children with SDCP and typically developing (TD) children? METHODS: Eleven children with SDCP (GMFCS I-II) and eleven age and gender-matched control TD children with an age range of 7-12 years were enrolled...
October 1, 2018: Gait & Posture
D Kiernan, R O'Sullivan
BACKGROUND: Crouch gait is a common pattern in children with CP. Little investigation has been performed as to the role of the trunk during crouch gait. A compensatory movement of the trunk may alter the position of the ground reaction force with the effect of reducing the moment arm about the knee or hip. While this may benefit these joints in the context of reduced loading, there may be implications further up the kinematic chain at the level of the lumbar spine. RESEARCH QUESTION: Are compensatory movements of the trunk present during crouch gait in children with CP and are levels of loading at the lower lumbar spine affected? METHODS: A full barefoot lower limb and trunk 3-dimensional kinematic and kinetic analysis, with kinetics estimated at the spinal position of L5/S1, was performed on 3 groups of children, namely CP Crouch, CP No-Crouch and TD...
September 6, 2018: Gait & Posture
Zhixian Gao, Lin Chen, Qiliang Xiong, Nong Xiao, Wei Jiang, Yuan Liu, Xiaoying Wu, Wensheng Hou
Background: Synergistic recruitment of muscular activities is a generally accepted mechanism for motor function control, and motor dysfunction, such as cerebral palsy (CP), destroyed the synergistic electromyography activities of muscle group for limb movement. However, very little is known how motor dysfunction of CP affects the organization of the myoelectric frequency components due to the abnormal motor unit recruiting patterns. Objectives: Exploring whether the myoelectric activity can be represented with synergistic recruitment of surface electromyography (sEMG) frequency components; evaluating the effect of CP motor dysfunction on the synergistic recruitment of sEMG oscillations...
2018: Frontiers in Neurology
Yosra Cherni, Annie Pouliot Laforte, Audrey Parent, Pierre Marois, Mickael Begon, Laurent Ballaz
BACKGROUND AND PURPOSE: The strategies for walking fast have never been reported in children with cerebral palsy who walk in crouch gait. This study aimed to assess to what extent children who walk in crouch gait are able to increase their gait speed and to report the corresponding three-dimensional kinematic adaptations. METHODS: Eleven children and adolescents (aged between 7 and 17 years) with bilateral cerebral palsy, who walk in crouch gait, were asked to walk at their self-selected comfortable speed and then as fast as possible without running...
September 28, 2018: Disability and Rehabilitation
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...
October 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 (MKS) in seating systems aggravates hip displacement in children with cerebral palsy (CP). DESIGN: Retrospective chart review. SETTING: Rehabilitation department of tertiary university hospital. PARTICIPANTS: Children with CP (N=76) 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 MKS...
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
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