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Knee cerebral palsy

Chris A McGibbon, Andrew Sexton, Glen Hughes, Adam Wilson, Melony Jones, Colleen O'Connell, Kim Parker, Catherine Adans-Dester, Anne O'Brien, Paolo Bonato
To evaluate a new portable toolkit for quantifying upper and lower extremity muscle tone in patients with upper motor neuron syndrome (UMNS).
 Design: 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, >6mo post acquired brain injury, spinal cord injury, multiple sclerosis and cerebral palsy, and a sample of healthy age-matched adult controls...
July 18, 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...
July 6, 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...
June 25, 2018: Gait & Posture
Rory O'Sullivan, Frances Horgan, Tim O'Brien, Helen French
AIM: To systematically review the natural history of crouch gait in bilateral cerebral palsy (CP) in the absence of surgical intervention and to review any relationship between clinical variables and progression of knee crouch. METHODS: Relevant literature was identified by searching article databases (PubMed, CINAHL, EMBASE, and Web of Science). Included studies reported on participants with bilateral CP who had 3-dimensional gait analysis on at least two occasions with no surgical interventions between analyses...
June 26, 2018: Research in Developmental Disabilities
M Vinti, N Bayle, A Merlo, G Authier, S Pesenti, J-L Jouve, B Chabrol, J-M Gracies, C Boulay
Objectives: Muscle shortening and spastic cocontraction in ankle plantar flexors may alter gait since early childhood in cerebral palsy (CP). We evaluated gastrosoleus complex (GSC) length, and gastrocnemius medialis (GM) and peroneus longus (PL) activity during swing phase, in very young hemiparetic children with equinovalgus. Methods: This was an observational, retrospective, and monocentric outpatient study in a pediatric hospital. Ten very young hemiparetic children (age 3 ± 1 yrs) were enrolled...
2018: BioMed Research International
Fu-Hui Dong
The miminally-invasive techniques of traditional Chinese medicine(TCM) uses different types of acupuncture needles to treat diseased locations with special techniques. These techniques include different methods of insertion and closed incision (press cutting, sliding cutting, scrape cutting, etc.). This needling technique is based on the traditional Chinese medicine theories of Pi Bu (cutaneous), Jing Jin (sinew), Jing Luo (meridian), Wu Ti (five body structure components) and Zang Fu (organ system). Commonly used needles include: needle Dao , needle with edge, Pi needle, Shui needle, Ren needle, Gou needle, Chang Yuan needle, Bo needle and so on...
June 25, 2018: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
N Peeters, B Hanssen, F Cenni, S H Schless, N De Beukelaer, M Degelaen, C Van den Broeck, A Van Campenhout, K Desloovere, L Bar-On
INTRODUCTION: Ankle joint hyper-resistance in children with spastic cerebral palsy (SCP) is commonly treated with Botulinum Toxin-A (BoNT-A) injections in the medial gastrocnemius (MG) combined with lower-leg casting. The overall aim of this combined treatment is to reduce spasticity and increase range of motion (1). Since hyper-resistance assessment mainly focuses on the joint level, whereas the treatment is directed at the muscle, it is worthwhile investigating the individual effects of BoNT-A and casting on MG and tendon lengths, to provide insight into the working mechanisms and to help improving treatment efficacy...
June 19, 2018: Gait & Posture
Norbert Stiel, Kornelia Babin, Eik Vettorazzi, Sandra Breyer, Nicola Ebert, Martin Rupprecht, Ralf Stuecker, Alexander S Spiro
Background and purpose - Fixed knee flexion deformity in children is a common problem in various diseases including myelomeningocele and cerebral palsy. Until now, only a few studies focusing on the surgical procedure of anterior distal femoral hemiepiphysiodesis have been published. We analyzed outcome and correction rate in the largest case series to date of patients treated by staples or 8-plates. Patients and methods - We reviewed the medical records of all patients with fixed knee flexion deformity who were treated with anterior distal femoral hemiepiphysiodesis using either staples or 8-plates between the years 2002 and 2017 (73 patients; 130 knees)...
June 14, 2018: Acta Orthopaedica
Marianna Romei, Laura M Oudenhoven, Petra E M van Schie, Willem J R van Ouwerkerk, Marjolein M van der Krogt, Annemieke I Buizer
BACKGROUND: Short-term benefit on gait of selective dorsal rhizotomy (SDR) surgery, which relieves spasticity of the lower extremities has been demonstrated in children with cerebral palsy (CP). However very little is known of the evolution of gait when patients become adolescents and young adults. RESEARCH QUESTION: How does the gait pattern evolve in adolescents and young adults who underwent SDR during childhood? METHODS: A longitudinal study was performed including 19 ambulant patients with spastic diplegia due to CP or other causes (mean age at SDR: 6...
June 4, 2018: Gait & Posture
Seoyoung Choi, Yong Beom Shin, Soo-Yeon Kim, Jonghyun Kim
BACKGROUND: To provide effective interventions for spasticity, accurate and reliable spasticity assessment is essential. For the assessment, the Modified Tardieu Scale (MTS) has been widely used owing to its simplicity and convenience. However, it has poor or moderate accuracy and reliability. METHODS: We proposed a novel inertial measurement unit (IMU)-based MTS assessment system to improve the accuracy and reliability of the MTS itself. The proposed system consists of a joint angle calculation algorithm, a function to detect abnormal muscle reaction (a catch and clonus), and a visual biofeedback mechanism...
June 4, 2018: Journal of Neuroengineering and Rehabilitation
Ya-Ching Hung, Aryeh Spingarn
BACKGROUND: Information on whole-body coordination involving bimanual coordination for children with unilateral spastic cerebral palsy (USCP) is limited. RESEARCH QUESTION: The purpose of the current study is to test the hypothesis that during a whole-body pick up task, children with USCP will organize their whole- body movements and bimanual coordination differently than typically-developing children (TDC). METHODS: Twelve children with USCP (average age: 8...
May 24, 2018: Gait & Posture
Elyse Passmore, H Kerr Graham, Marcus G Pandy, Morgan Sangeux
BACKGROUND: Torsional deformities of the femur and tibia are associated with gait impairments and joint pain. Several studies have investigated these gait deviations in children with cerebral palsy. However, relatively little is known about gait deviations in children with idiopathic torsion and debate ensues about the management of these patients. RESEARCH QUESTION: What are the effects of idiopathic increased femoral neck anteversion and external tibial torsion on lower-limb kinematics, kinetics and joint loading during gait in children and adolescents...
June 2018: Gait & Posture
Mayumi Matsuda, Nobuaki Iwasaki, Yuki Mataki, Hirotaka Mutsuzaki, Kenichi Yoshikawa, Kazushi Takahashi, Keiko Enomoto, Kumiko Sano, Aoi Kubota, Tomohiro Nakayama, Junko Nakayama, Haruka Ohguro, Masafumi Mizukami, Kazuhide Tomita
PURPOSE: The Hybrid Assistive Limb® (HAL®, CYBERDYNE) is a wearable robot that provides assistance to a patient while they are walking, standing, and performing leg movements based on the wearer's intended movement. The effect of robot-assisted training using HAL® for cerebral palsy (CP) is unknown. Therefore, we assessed the effect of robot-assisted training using HAL® on patients with CP, and compared walking and gross motor abilities between pre-intervention and post-intervention...
May 14, 2018: Brain & Development
Barbara Kelly, Marilyn MacKay-Lyons, Susan Berryman, Joe Hyndman, Ellen Wood
AIM: To study the effects of single versus serial casting post-Botulinum toxin A (BoNT-A) injections on hypoextensibility of triceps surae in children, 2-7 years old, with cerebral palsy and equinus gait. METHODS: A randomized, stratified, parallel, two-group trial was conducted at a pediatric health center with assessments at baseline, precast, postcast and, 1-, 2-, and 6-month follow-ups. One week following BoNT-A injections into triceps surae muscle, a single below-knee cast (n = 10) or 3 serial casts (n = 10) were applied for 3 weeks...
May 17, 2018: Physical & Occupational Therapy in Pediatrics
Ian N Bezodis, James Cowburn, Adam Brazil, Rhian Richardson, Cassie Wilson, Timothy A Exell, Gareth Irwin
Cerebral palsy is known to generally limit range of motion and force producing capability during movement. It also limits sprint performance, but the exact mechanisms underpinning this are not well known. One elite male T36 multiple-Paralympic sprint medallist (T36) and 16 well-trained able-bodied (AB) sprinters each performed 5-6 maximal sprints from starting blocks. Whole-body kinematics (250 Hz) in the block phase and first two steps, and synchronised external forces (1,000 Hz) in the first stance phase after block exit were combined to quantify lower limb joint kinetics...
May 16, 2018: Sports Biomechanics
Yeo Reum Choe, Joo Sup Kim, Kee Hoon Kim, Tae Im Yi
Objective: To investigate the relationship between functional level and muscle thickness (MT) of the rectus femoris (RF) and the gastrocnemius (GCM) in young children with cerebral palsy (CP). Methods: The study participants were comprised of 26 children (50 legs) with spastic CP, aged 3-6 years, and 25 age-matched children with typical development (TD, 50 legs). The MT of the RF, medial GCM, and lateral GCM was measured with ultrasound imaging. The functional level was evaluated using the Gross Motor Function Measurement-88 (GMFM-88), Gross Motor Function Classification System (GMFCS), and based on the mobility area of the Korean version of the Modified Barthel Index (K-MBI)...
April 2018: Annals of Rehabilitation Medicine
Yoona Cho, Eun Sook Park, Han Kyul Park, Jae Eun Park, Dong-Wook Rha
Objective: To find factors affecting hip and femoral deformities in children with spastic cerebral palsy (CP) by comparing various clinical findings with imaging studies including plain radiography and computed tomography (CT) imaging. Methods: Medical records of 709 children with spastic CP who underwent thorough baseline physical examination and functional assessment between 2 to 6 years old were retrospectively reviewed. Fifty-seven children (31 boys and 26 girls) who had both plain radiography of the hip and three-dimensional CT of the lower extremities at least 5 years after baseline examination were included in this study...
April 2018: Annals of Rehabilitation Medicine
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