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Cerebral palsy, foot

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
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
Jean-Sébastien Bourseul, Mael Lintanf, Philippe Saliou, Sylvain Brochard, Christelle Pons
OBJECTIVE: Different ankle-foot orthoses (AFO) are often prescribed in children with cerebral palsy (PC) although their efficiency on gait remains unclear. PURPOSE: (1) To determine the effect of AFOs on gait in children with CP and (2) to evaluate the effect of each types of AFO. MATERIAL AND METHODS: Studies in English with control condition (barefoot or shoes) assessing effect of AFO about children with CP gait were search on the Pubmed, CINAHL+, Web of Science, Cochrane Library databases...
September 2016: Annals of Physical and Rehabilitation Medicine
Nigar Dursun, Tugba Gokbel, Melike Akarsu, Erbil Dursun
OBJECTIVE: Physical therapy (PT) and botulinum toxin-A (BTX-A) injections are widely used in the treatment of spastic equinus foot due to cerebral palsy. The aim of this study was to show effects of intermittent serial casting (SC) in addition to standard treatment on spasticity, passive range of motion (PROM), and gait. DESIGN: Fifty-one ambulatory patients, treated by BTX-A to plantar flexor muscles, were randomly assigned to casting or control groups in a 2:1 ratio...
September 14, 2016: American Journal of Physical Medicine & Rehabilitation
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
Gloria Tapias, Mar García-Romero, Carlos Crespo, Maribel Cuesta, Carles Forné, Samuel Ignacio Pascual-Pascual
OBJECTIVE: Cost-minimization analysis of onabotulinumtoxinA and abobotulinumtoxinA, taking into account the real dose administered to children with spasticity associated with dynamic equinus foot deformity due to cerebral palsy. METHOD: A single centre, observational, longitudinal, and retrospective study which included spastic paediatric patients aged 2-to-18-years and treated with onabotulinumtoxinA or abobotulinumtoxinA from December 1995 to October 2012, in the Paediatric Neurology Unit of a first-level Spanish hospital...
September 2016: Farmacia Hospitalaria
S T J Tsang, D McMorran, L Robinson, J Herman, J E Robb, M S Gaston
The aim of this study was to evaluate the outcome of combined tibialis anterior tendon shortening (TATS) and calf muscle-tendon lengthening (CMTL) in spastic equinus. Prospectively collected data was analysed in 26 patients with hemiplegic (n=13) and diplegic (n=13) cerebral palsy (CP) (GMFCS level I or II, 14 males, 12 females, age range 10-35 years; mean 16.8 years). All patients had pre-operative 3D gait analysis and a further analysis at a mean of 17.1 months (±5.6months) after surgery. None was lost to follow-up...
August 17, 2016: Gait & Posture
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
Zachary Lerner, Diane Damiano, Hyung-Soon Park, Andrew Gravunder, Thomas Bulea
Crouch gait, a pathological pattern of walking characterized by excessive knee flexion, is one of the most common gait disorders observed in children with cerebral palsy (CP). Effective treatment of crouch during childhood is critical to maintain mobility into adulthood, yet current interventions do not adequately alleviate crouch in most individuals. Powered exoskeletons provide an untapped opportunity for intervention. The multiple contributors to crouch, including spasticity, contracture, muscle weakness, and poor motor control make design and control of such devices challenging in this population...
July 27, 2016: IEEE Transactions on Neural Systems and Rehabilitation Engineering
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
Lika'a Fasih Y Al-Kzayer, Peter Keizer, Farah T Abdulraheem, Kenji Sano, Minoru Kamata, Kazuo Sakashita, Laith A Y Habbaba, Kenichi Koike
BACKGROUND: Kaposi's sarcoma (KS), an endothelial neoplasm, is associated with human herpes virus (HHV) -8 infection. KS has four clinical sub-types: Mediterranean/classic, African/endemic, human immunodeficiency virus (HIV) -associated/epidemic, and transplantation-related/iatrogenic. Immunosuppression is an important cofactor in KS process. Classic KS (CKS) is exceedingly rare in children and when occurs, it is much more disseminated than adults. The epidemic, HIV-associated and the iatrogenic forms of childhood KS are a result of a profound and acquired T-cell deficiency...
2016: BMC Pediatrics
Michael John Dolan, Graham Iain Henderson
PURPOSE: To determine the prevalence of control devices for electrically powered wheelchairs (EPWs), related characteristic features and users' views on their utility. METHOD: Postal survey of users of a regional NHS wheelchair service using a purpose-designed questionnaire (n = 262, ≥18 years old). RESULTS: Mean age 54.4 years, female 56.8%, mean duration EPW use 10.1 years, mean usage 6.7 days per week and 9.2 h per day. Largest diagnostic groups: Multiple Sclerosis 28...
July 19, 2016: Disability and Rehabilitation. Assistive Technology
Pieter Meyns, Jacques Duysens, Kaat Desloovere
In this observational case-control study we aimed to determine whether altered arm postures in children with unilateral CP (uniCP) are related to gait instability in a specific direction. Antero-posterior and medio-lateral Foot Placement Estimator instability measures and arm posture measures (vertical and antero-posterior hand position, sagittal and frontal upper arm elevation angle) were determined in eleven uniCP (7 years-10 months) and twenty-four typically developing children (9 years-6 months) at two walking speeds...
September 2016: Gait & Posture
Jolanta Pauk, Mikhail Ihnatouski, Kristina Daunoraviciene, Uladimir Laskhousky, Julius Griskevicius
PURPOSE: Spastic diplegia is the most common form of cerebral palsy. It presents with symmetric involvement of the lower limbs and upper limbs. Children with spastic diplegia frequently experience problems with motor control, spasticity, and balance which lead to gait abnormalities. The aim of this study is twofold. Firstly, to determine the differences in spatial-temporal gait parameters and magnitude of plantar pressure distribution between children with spastic diplegia (CP) and typical children...
2016: Acta of Bioengineering and Biomechanics
Joline E Brandenburg, Sarah F Eby, Pengfei Song, Shirley Kingsley-Berg, William Bamlet, Gary C Sieck, Kai-Nan An
AIM: The aim of this study was to compare passive muscle stiffness in children with cerebral palsy (CP) and children with typical development using a novel ultrasound technique: ultrasound shear wave elastography (SWE). METHOD: We conducted a prospective study of 13 children with CP (six females and seven males, median age 5y 1mo [interquartile range 4y 4mo-7y 8mo]) and 13 children with typical development (six females and seven males, median age 5y 3mo [interquartile range 4y 4mo-9y 4mo])...
July 4, 2016: Developmental Medicine and Child Neurology
Lizeth H Sloot, Lynn Bar-On, Marjolein M van der Krogt, Erwin Aertbeliën, Annemieke I Buizer, Kaat Desloovere, Jaap Harlaar
AIM: We compared the outcomes of manual and motorized instrumented ankle spasticity assessments in children with cerebral palsy (CP). METHOD: Ten children with spastic CP (three males, seven females; mean age 11y [standard deviation 3y], range 6-14y; Gross Motor Function Classification System levels I-III) were included. During motorized assessments, fast (100°/s) rotations were imposed around the ankle joint by a motor-driven footplate; during manual assessments, rotations of comparable speed were applied by a therapist using a foot orthotic...
July 1, 2016: Developmental Medicine and Child Neurology
Maria Del Pilar Duque Orozco, Oussama Abousamra, Chris Church, Nancy Lennon, John Henley, Kenneth J Rogers, Julieanne P Sees, Justin Connor, Freeman Miller
Assessment of gait abnormalities in cerebral palsy (CP) is challenging, and access to instrumented gait analysis is not always feasible. Therefore, many observational gait analysis scales have been devised. This study aimed to evaluate the interobserver reliability, intraobserver reliability, and validity of Edinburgh visual gait score (EVGS). Video of 30 children with spastic CP were reviewed by 7 raters (10 children each in GMFCS levels I, II, and III, age 6-12 years). Three observers had high level of experience in gait analysis (10+ years), two had medium level (2-5 years) and two had no previous experience (orthopedic fellows)...
September 2016: Gait & Posture
Glendaliz Bosques, Rebecca Martin, Leah McGee, Cristina Sadowsky
The use of therapeutic electrical stimulation for medical purposes is not new; it has been described in medical textbooks since the 18th century, but its use has been limited due to concerns for tolerance and lack of research showing efficacy. The purpose of this review is to discuss the potential clinical applicability, while clarifying the differences in electrical stimulation (ES) treatments and the theory behind potential benefits to remediate functional impairments in youth.The literature review was performed as follows: A total of 37 articles were reviewed and the evidence for use in pediatric diagnoses is reported...
May 31, 2016: Journal of Pediatric Rehabilitation Medicine
Matthias Hösl, Harald Böhm, Adamantios Arampatzis, Antonia Keymer, Leonhard Döderlein
BACKGROUND: Plantarflexor tightness due to muscle degenerations has been frequently documented in children with spastic cerebral palsy but the contractile behavior of muscles during ambulation is largely unclear. Especially the adaptability of gastrocnemius muscle contraction on sloped surface could be relevant during therapy. METHODS: Medial gastrocnemius contractions were measured during flat-forward, uphill (+12% incline) and backward-downhill (-12% decline) treadmill gait in 15 children with bilateral cerebral palsy, walking in crouch, and 17 typically developing controls (age: 7-16years) by means of ultrasound and motion analysis...
July 2016: Clinical Biomechanics
E Němejcová, A Schejbalová, T Trč, V Havlas
UNLABELLED: PURPOSE OF THE STUDY The aim of the study was to evaluate, on the basis of radiographic findings and AOFAS scores, the results of the Grice extra-articular subtalar arthrodesis for treatment of planovalgus foot deformity in cerebral palsy patients. MATERIAL AND METHODS A total of 38 patients (50 feet) with cerebral palsy indicated to the Grice procedure for planovalgus foot deformity between 2006 and 2010 were assessed. The group comprised 18 girls and 20 boys, of whom 10 had spastic quadriparesis (four undergoing bilateral surgery), three had triparesis, four had hemiparesis and 21 had diparesis (treated on both sides in eight)...
2016: Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca
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