Changes in foot posture evaluated with dynamic pedobarography over the course of childhood in ambulatory youth with cerebral palsy.

Purpose: Foot deformities are prevalent in children with cerebral palsy, but there is limited research on the progression of foot posture during growth. Our study aimed to evaluate the change in dynamic foot posture in children with cerebral palsy.

Methods: Children with cerebral palsy, aged 17-40 months, were recruited to participate in this Institutional Review Board-approved prospective longitudinal study by having serial foot posture evaluations.

Can the Shriners Hospital Upper Extremity Evaluation (SHUEE) Detect Change in Dynamic Position and Spontaneous Function of the Upper Limb in People With Hemiplegic Cerebral Palsy?

Background: The Shriners Hospital Upper Extremity Evaluation (SHUEE) is a video-based measure designed to assess upper extremity function in people with cerebral palsy (CP). The SHUEE completes both dynamic positional analysis (DPA; position during functional activities) and spontaneous functional analysis (spontaneous use of the involved limb). Although the SHUEE has been suggested as a measure for planning upper limb interventions and evaluating outcomes, limited evidence of its ability to detect change exists.

The Effectiveness of Serial Casting in the Treatment of Recurrent Equinovarus in Children With Arthrogryposis.

Background: Arthrogryposis multiplex congenita (AMC) is characterized by joint contractures in 2 or more body areas, often resulting in clubfoot deformities that are typically stiffer than those seen in idiopathic clubfoot deformities. While surgery is routinely used to treat clubfoot in AMC, it has a high rate of recurrence and complications. Current literature suggests serial casting (SC) could be useful in treating clubfoot in AMC, though evidence of its effectiveness is limited.

Is Standing Function Improved After Orthopaedic Surgery in Children With Cerebral Palsy at GMFCS Levels III/IV?

Background: Children with cerebral palsy (CP) at Gross Motor Function Classification System (GMFCS) levels III/IV are at risk for losses in standing function during adolescence and transition to adulthood. Multilevel surgery (MLS) is an effective treatment to improve gait, but its effects on standing function are not well documented. The objectives of our study were to describe standing function in children with CP classified as GMFCS levels III/IV and evaluate change after MLS.

Walking activity after multilevel orthopedic surgery in children with cerebral palsy.

Aim: To determine how surgical burden and preoperative factors affect the recovery of walking activity after multilevel orthopedic surgery (MLS).

Method: In this retrospective study, inclusion criteria were a diagnosis of cerebral palsy, MLS, and walking activity monitoring using a StepWatch device within 12 months pre-MLS and 24 months post-MLS. The outcome measure was total mean strides per day normalized to age and Gross Motor Function Classification System level.

Mobility and gait in adults with cerebral palsy: Evaluating change from adolescence.

Background: Previous studies have looked at the short-term effectiveness of conservative and surgical treatment of children with cerebral palsy (CP), but few have explored the long-term outcomes into adulthood using gait analysis and patient-reported outcome measures.

Research Question: How do gait, mobility, and patient-reported outcomes in adults with CP who received specialized pediatric orthopedic care change from adolescence?

Methods: We identified 645 adults with 1) CP, 2) age 25-45 years, and 3) an adolescent instrumented gait analysis (IGA) at our center. Measurement outcomes included physical examination, IGA, and select domains of the Patient-Reported Outcomes Measurement Information System (PROMIS).

The change in sagittal plane gait patterns from childhood to maturity in bilateral cerebral palsy.

Background: The longitudinal stability of sagittal gait patterns in diplegic cerebral palsy (CP), stratified using the Rodda classification, is currently unknown.

Research Question: What is the trajectory of sagittal plane gait deformities as defined by the Rodda classification in a large cohort treated with orthopedic surgery guided by gait analysis?

Methods: A retrospective study utilized gait analysis to evaluate sagittal gait parameters before age 8 and after age 15 years. Individual limbs were categorized at each time point according to the Rodda classification based on mean sagittal plane knee and ankle angle during stance.

Factors associated with walking activity in adults with cerebral palsy.

Background: This prospective study used instrumented gait analysis, patient-reported outcomes, and portable accelerometers to examine walking activity in adults with cerebral palsy (CP).

Research Question: This study aimed to provide objective data and evaluate factors associated with walking activity in adults with CP.

Methods: Participants with CP (ages 25-45 years) completed instrumented gait analysis and patient-reported outcomes, including the Patient Reported Outcome Measurement Information System (PROMIS) and Satisfaction with Life Score (SWLS), and wore a StepWatch for 8 days.

Semaphorin 3A mediated brain tumor stem cell proliferation and invasion in EGFRviii mutant gliomas.

Background: Glioblastoma multiforme (GBM) is the most common primary brain tumor in adults, with a median survival of approximately 15 months. Semaphorin 3A (Sema3A), known for its axon guidance and antiangiogenic properties, has been implicated in GBM growth. We hypothesized that Sema3A directly inhibits brain tumor stem cell (BTSC) proliferation and drives invasion via Neuropilin 1 (Nrp1) and Plexin A1 (PlxnA1) receptors.

The long-term outcome of pelvic asymmetry during gait in children with cerebral palsy following unilateral femoral derotation osteotomy.

In this retrospective study, children with cerebral palsy underwent a unilateral femoral derotation osteotomy and had a preoperative (PO), short-term postoperative (1-3 years), and a long-term postoperative (≥5 years) gait analysis. Patients were subdivided into groups by the PO pelvic presentation and Gross Motor Function Classification System level. In children with PO pelvic external rotation, femoral derotation osteotomy decreased the hip internal rotation and decreased the pelvic external rotation.

Glucocorticoids Target Ependymal Glia and Inhibit Repair of the Injured Spinal Cord.

Following injury, the mammalian spinal cord forms a glial scar and fails to regenerate. In contrast, vertebrate fish spinal cord tissue regenerates significantly to restore function. Cord transection in zebrafish () initially causes paralysis and neural cell death.

Long-term outcome of knee hyperextension in children with cerebral palsy.

This study evaluated knee hyperextension course in children with cerebral palsy over a 5-year follow-up. Knee hyperextension was identified in 308 knees, of which 97 had follow-up greater than 5 years. Between the tests, 40% of limbs had plantar flexor lengthening (PFL).

Comparison of three-dimensional multi-segmental foot models used in clinical gait laboratories.

Background: Many skin-mounted three-dimensional multi-segmented foot models are currently in use for gait analysis. Evidence regarding the repeatability of models, including between trial and between assessors, is mixed, and there are no between model comparisons of kinematic results.

Research Question: This study explores differences in kinematics and repeatability between five three-dimensional multi-segmented foot models.

The effect of plantar flexor lengthening on foot pressure in ambulatory children with cerebral palsy.

This study aimed to assess the effects of plantar flexor lengthening (PFL) on dynamic foot pressures of children with cerebral palsy using pedobarographs. Of 97 enrolled, 13 children with 18 legs had PFL. Age at surgery was 4.

The effect of continuous intrathecal baclofen therapy on ambulatory children with cerebral palsy.

The effect of a continuous intrathecal infusion of baclofen (CITB) was retrospectively studied in 19 ambulatory children with cerebral palsy (aged 12.4±4.9 years at CITB initiation).

Reliability and minimal detectable change in foot pressure measurements in typically developing children.

Background: In pedobarography, clinically meaningful comparison of measurements within or between subjects is limited by data variability and measurement error. This study aims to determine the components of the minimal detectable change (MDC) in impulse across all foot regions and the reliability of these measures.

Methods: A convenience sample of foot pressures from 108 visits by normal, healthy subjects aged 2-17 years was studied.

Single-Leg Squat Performance in Active Adolescents Aged 8-17 Years.

Agresta, CE, Church, C, Henley, J, Duer, T, and O'Brien, K. Single-leg squat performance in active adolescents aged 8-17 years. J Strength Cond Res 31(5): 1187-1191, 2017-More than 30 million U.

Biomechanical analysis of gait termination in 11-17year old youth at preferred and fast walking speeds.

In populations where walking and/or stopping can be difficult, such as in children with cerebral palsy, the ability to quickly stop walking may be beyond the child's capabilities. Gait termination may be improved with physical therapy. However, without a greater understanding of the mechanical requirements of this skill, treatment planning is difficult.

The effectiveness of posterior knee capsulotomies and knee extension osteotomies in crouched gait in children with cerebral palsy.

Crouched gait is common in children with cerebral palsy (CP), and there are various treatment options. This study evaluated the effectiveness of single-event multilevel surgery including posterior knee capsulotomy or distal femoral extension osteotomy to correct knee flexion contracture in children with CP. Gait analyses were carried out to evaluate gait preoperatively and postoperatively.

Reliability and validity of Edinburgh visual gait score as an evaluation tool for children with cerebral palsy.

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).

Recent Advances in Monoclonal Antibody Therapies for Multiple Sclerosis.

Introduction: Multiple sclerosis (MS) is the most common chronic inflammatory, demyelinating disease of the CNS and results in neurological disability. Existing immunomodulatory and immunosuppressive approaches lower the number of relapses but do not cure or reverse existing deficits nor improve long-term disability in MS patients.

Areas Covered: Monogenic antibodies were described as treatment options for MS, however the immunogenicity of mouse antibodies hampered the efficacy of potential therapeutics in humans.