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Cerebral palsy hip

Carolina Souza Neves da Costa, Sandra L Saavedra, Nelci Adriana Cicuto Ferreira Rocha, Marjorie H Woollacott
BACKGROUND: External support has been viewed as an important biomechanical constraint for children with deficits in postural control. Nonlinear analysis of head stability is necessary to confirm benefits of interaction between external trunk support and level of trunk control. OBJECTIVE: To compare the effect of biomechanical constraints (trunk support) on neural control of head stability during development of trunk control. DESIGN: Quasi-experimental repeated measure study...
October 6, 2016: Physical Therapy
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
Sanjay Chougule, John Dabis, Aviva Petrie, Karen Daly, Yael Gelfer
BACKGROUND: Reimer's migration percentage (MP) is the most established radiographic risk factor for hip migration in cerebral palsy (CP), and it assists surgical decision-making. The head-shaft angle (HSA) measures the valgus of the head and neck in relation to the shaft and may also be a useful predictor of hip migration at a young age. This study first defined normal values and investigated whether the head-shaft angle (HSA) is a continuous risk factor for hip migration in CP. METHODS: Three hundred and fifty AP pelvic radiographs of 100 consecutive children comprising the hip surveillance programme in our region were analysed for MP and HSA...
October 12, 2016: Journal of Children's Orthopaedics
Petra Marsico, Amir Tal-Akabi, Hubertus J A van Hedel
BACKGROUND: In children with cerebral palsy (CP), stiffness, caused by contractile and non-contractile structures, can influence motor performance. This study sought to determine whether the nerve mobility had a relevant impact on motor performance in children with CP. We hypothesized that a positive Straight Leg Raise (SLR) test, as well as smaller SLR hip angle, would relate to lower leg muscle strength, reduced motor capacity and less motor performance in children with CP. METHODS: We applied a cross-sectional analysis on data including SLR, leg muscle strength, Gross Motor Function Measure (GMFM-66) and number of activity counts during daily life from thirty children with CP (6-18 years)...
October 7, 2016: BMC Neurology
Aizhen Qiu, Zhongxiu Yang, Jiping Wang, Taotao Wang
The aim of the study was to assess the clinical value of ultrasound screenings for the developmental dysplasia of the hip (DDH) and explore its etiology in high-risk infants with cerebral palsy in follow-up visits. A group of 98 cases of infants at high-risk of cerebral palsy who received rehabilitation treatment between July, 2009 and July, 2010 were selected. Infants included 58 men and 40 women, aged <6 months and not lost to follow-up visits. Ultrasound (using Graf static inspection) screening of hips was performed and the infants with abnormalities were given clinical intervention, and 1- to 2-year-old infants were given outpatient follow-ups...
October 2016: Experimental and Therapeutic Medicine
C Morin, C Ursu, C Delecourt
INTRODUCTION: The everyday life of a non-ambulatory adolescent or young adult with cerebral palsy can be severely impaired by a painful or stiff hip. The usual surgical solutions such as proximal femoral resection (PFR) are not entirely satisfactory for pain relief, and are mutilating. HYPOTHESIS: A retrospective study assessed the impact of total hip replacement (THR) on such impairment, on the hypothesis that it is more effective than PFR in relieving pain, without aggravating disability...
September 30, 2016: Orthopaedics & Traumatology, Surgery & Research: OTSR
Bruno Dohin, Elie Haddad, Hassan Al Khoury Salem, Mohamed Merhez Kilani
OBJECTIVE: Hip internal rotation (HIR) during gait is one of the main functional disorders related to cerebral palsy (CP) in children. Most of the procedures proposed rotational osteotomy of the femur (FRO), (and/or tibia). However, multilevel surgery (SEMLS) including bone procedure, implicates more difficult and longer rehabilitation. When bone deformity is moderate, the authors hypothesized that FRO could be avoided. They developed a soft tissues procedure to improve HIR. The aim of the study was assessment of the procedure...
September 2016: Annals of Physical and Rehabilitation Medicine
M Attias, A Bonnefoy-Mazure, G De Coulon, L Cheze, S Armand
Contracture is a permanent shortening of the muscle-tendon-ligament complex that limits joint mobility. Contracture is involved in many diseases (cerebral palsy, stroke, etc.) and can impair walking and other activities of daily living. The purpose of this study was to quantify the reliability of an exoskeleton designed to emulate lower limb muscle contractures unilaterally and bilaterally during walking. An exoskeleton was built according to the following design criteria: adjustable to different morphologies; respect of the principal lines of muscular actions; placement of reflective markers on anatomical landmarks; and the ability to replicate the contractures of eight muscles of the lower limb unilaterally and bilaterally (psoas, rectus femoris, hamstring, hip adductors, gastrocnemius, soleus, tibialis posterior, and peroneus)...
September 19, 2016: Gait & Posture
C Druschel, K Heck, C Kraft, R Placzek
OBJECTIVE: PemberSal osteotomy to improve femoral head coverage by rotating the acetabular roof ventrally and laterally. INDICATIONS: Insufficient coverage of the femoral head, and can be combined with other surgical procedures such as femoral intertrochanteric varus-derotation osteotomy and open reduction for developmental dysplasia and dislocation of the hip or to improve sphericity and containment in Legg-Calvé-Perthes disease. This specific acetabuloplasty can only be performed in patients with an open epiphyseal growth-plate...
September 14, 2016: Operative Orthopädie und Traumatologie
Cecilia Lidbeck, Åsa Bartonek, Priti Yadav, Kristina Tedroff, Per Åstrand, Kerstin Hellgren, Elena M Gutierrez-Farewik
BACKGROUND: In children with bilateral cerebral palsy (CP) maintaining a standing position can be difficult. The fundamental motor task of standing independently is achieved by an interaction between the visual, somatosensory, and vestibular systems. In CP, the motor disorders are commonly accompanied by sensory and perceptual disturbances. Our aims were to examine the influence of visual stimuli on standing posture in relation to standing ability. METHODS: Three dimensional motion analysis with surface electromyography was recorded to describe body position, body movement, and muscle activity during three standing tasks: in a self-selected position, while blindfolded, and during an attention-demanding task...
2016: BMC Neurology
Stefan Schmid, Jacqueline Romkes, William R Taylor, Silvio Lorenzetti, Reinald Brunner
BACKGROUND AND PURPOSE: Foot equinus and leg length discrepancy (LLD) are common problems in hemiplegic cerebral palsy (hCP), both causing secondary deviations of pelvic motion during gait. It can therefore be assumed that the spinal deviations observed in hCP patients are secondary as a compensation for the position of the pelvis arising from the disturbed leg function. This study investigated the effects of correcting lower extremity function by orthotics on spinal gait kinematics in hCP patients...
September 2016: Gait & Posture
Fabiane Nunes Antunes, Alexandre Severo do Pinho, Ana Francisca Rozin Kleiner, Ana Paula Salazar, Giovana Duarte Eltz, Alcyr Alves de Oliveira Junior, Fernanda Cechetti, Manuela Galli, Aline Souza Pagnussat
Hippotherapy is often carried out for the rehabilitation of children with Cerebral Palsy (CP), with the horse riding at a walking pace. This study aimed to explore the immediate effects of a hippotherapy protocol using a walk-trot pace on spatio-temporal gait parameters and muscle tone in children with Bilateral Spastic CP (BS-CP). Ten children diagnosed with BS-CP and 10 healthy aged-matched children (reference group) took part in this study. The children with BS-CP underwent two sessions of hippotherapy for one week of washout between them...
August 9, 2016: Research in Developmental Disabilities
Ayman Assi, Christophe Sauret, Abir Massaad, Ziad Bakouny, Hélène Pillet, Wafa Skalli, Ismat Ghanem
Localization of the hip joint center (HJC) is essential in computation of gait data. EOS low dose biplanar X-rays have been shown to be a good reference in evaluating various methods of HJC localization in adults. The aim is to evaluate predictive and functional techniques for HJC localization in typically developing (TD) and cerebral palsy (CP) children, using EOS as an image based reference. Eleven TD and 17 CP children underwent 3D gait analysis. Six HJC localization methods were evaluated in each group bilaterally: 3 predictive (Plug in Gait, Bell and Harrington) and 3 functional methods based on the star arc technique (symmetrical center of rotation estimate, center transformation technique and geometrical sphere fitting)...
July 2016: Gait & Posture
C Putz, S I Wolf, A Geisbüsch, M Niklasch, L Döderlein, T Dreher
BACKGROUND: Internal rotation gait constitutes a complex gait disorder in bilateral spastic cerebral palsy (BSCP) including static torsional and dynamic components resulting in lever arm dysfunction. Although femoral derotation osteotomy (FDO) is a standard procedure to correct increased femoral anteversion in children, unpredictable outcome has been reported. The effect of FDO when it is done as part of single-event multilevel surgery (SEMLS) in adulthood has not been investigated. METHODS: In this study mid-term data of 63 adults with BSCP and internal rotation gait, undergoing SEMLS including FDO were analyzed pre- and 1...
September 2016: Gait & Posture
Rachel DiFazio, Benjamin Shore, Judith A Vessey, Patricia E Miller, Brian D Snyder
BACKGROUND: The primary aim of this study was to evaluate the relationship of the migration percentage (a radiographic metric quantifying hip displacement) in children with Gross Motor Function Classification System (GMFCS) level-IV or V cerebral palsy and spastic hip dysplasia to the acetabular index and the health-related quality of life (HRQOL) as measured with the Caregiver Priorities and Child Health Index of Life with Disabilities (CPCHILD) before and after reconstructive hip surgery...
July 20, 2016: Journal of Bone and Joint Surgery. American Volume
Susan A Rethlefsen, Gideon Blumstein, Robert M Kay, Frederick Dorey, Tishya A L Wren
AIM: To examine the impact of age, surgery, and Gross Motor Function Classification System (GMFCS) level on the prevalence of gait problems in children with cerebral palsy (CP). METHOD: Gait analysis records were retrospectively reviewed for ambulatory patients with CP. Gait abnormalities were identified using physical exam and kinematic data. Relationships among age, sex, previous surgery, GMFCS level, and prevalence of gait abnormalities associated with crouch and out-toeing, and equinus and in-toeing were assessed using univariable and multivariable logistic regression...
July 15, 2016: Developmental Medicine and Child Neurology
Abir Massaad, Ayman Assi, Ziad Bakouny, Christophe Sauret, Nour Khalil, Wafa Skalli, Ismat Ghanem
Skeletal abnormalities, affecting posture and walking pattern, increase with motor impairment in children with cerebral palsy (CP). However, it is not known whether these skeletal malalignments occur in children with slight motor impairment. Our aim was to evaluate skeletal malalignment at the level of the pelvis and lower limbs in ambulant children with CP, with slight motor impairment, using a low dose biplanar X-ray technique. Twenty-seven children with spastic CP (mean age: 10.9±4years, 7 Hemiplegia, 20 Diplegia, GMFCS levels I:17, II:10), with no previous treatments at the hips and knees, underwent EOS(®) biplanar X-rays...
September 2016: Gait & Posture
Christian A Refakis, Keith D Baldwin, David A Spiegel, Wudbhav N Sankar
BACKGROUND: Although many studies have separately investigated the treatment of developmental dysplasia of the hip and spastic hip disease, little data exist regarding the treatment of infants with dislocated hips and underlying spasticity. The purpose of this study was to review our results after the surgical treatment of these infants. METHODS: We retrospectively reviewed all children below 3 years of age who underwent hip reconstruction for dislocated hips in the setting of cerebral palsy or other spastic/high-tone neuromuscular disease...
July 2, 2016: Journal of Pediatric Orthopedics
Jae Young Park, Young Choi, Byung Chae Cho, Sang Young Moon, Chin Youb Chung, Kyoung Min Lee, Ki Hyuk Sung, Soon-Sun Kwon, Moon Seok Park
Progression of hip displacement is common in patients with cerebral palsy (CP). We aimed to investigate the rate of progression of hip displacement in patients with CP by assessing changes in radiographic indices according to Gross Motor Function Classification System (GMFCS) level during hip surveillance. We analyzed the medical records of patients with CP aged < 20 years who underwent at least 6 months interval of serial hip radiographs before any surgical hip intervention, including reconstructive surgery...
July 2016: Journal of Korean Medical Science
Kerstin Reidy, Christoph Heidt, Stefan Dierauer, Hanspeter Huber
BACKGROUND: Hip reconstructive surgery in cerebral palsy (CP) patients necessitates either femoral varus derotational osteotomy (VDRO) or pelvic osteotomy, or both. The purpose of this study is to review the results of a moderate varisation [planned neck shaft angle (NSA) of 130°] in combination with pelvic osteotomy for a consecutive series of patients. METHODS: Patients with CP who had been treated at our institution for hip dysplasia, subluxation or dislocation with VDRO in combination with pelvic osteotomy between 2005 and 2010 were reviewed...
August 2016: Journal of Children's Orthopaedics
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