Patients and Parents' Satisfaction and Self-Reported Evaluation After Single-Event Multilevel Surgery in Cerebral Palsy.

Purpose: The aim of this study was to analyze the results of single-event multilevel surgery (SEMLS) in cerebral palsy (CP) based on objective gait outcomes and self-reported evaluations.

Methods: In total, 258 patients with spastic diplegic CP, GMFCS I-III, who underwent SEMLS and with preoperative and postoperative gait analyses, were included in the SEMLS group (SG). The same database was used to compose the control group (CG) formed of 88 subjects who had performed at least 2 gait analyses and did not undergo surgical intervention between tests.

Comparison between semitendinosus transfer to distal femur and medial hamstrings surgical lengthening for treatment of flexed knee gait in cerebral palsy.

Purpose: Hamstrings surgical lengthening (HSL) has been frequently used for the treatment of flexed knee gait in cerebral palsy; however, recurrence of knee flexion deformity (KFD) and increase of anterior pelvic tilt (APT) were reported in a long-term follow-up.

Research Question: The aim of this study was to compare semitendinosus transfer to distal femur (STTX) and semitendinosus surgical lengthening (STL) regarding the reduction of KFD and the increase of APT after flexed knee gait treatment.

Methods: One hundred and eleven patients were evaluated and they were divided into two groups according to surgical procedures at knees: group A (65 patients/130 knees), including patients who received medial HSL as part of multilevel approach; group B (46 patients/92 knees), represented by patients who underwent orthopedic surgery including an STTX instead of STL.

The effect of the Majestro-Frost procedure on internal hip rotation during gait in patients with cerebral palsy.

Background: Muscle imbalance is related to persistent internal hip rotation (IHR) after femoral derotation osteotomy (FDO) in cerebral palsy (CP). The aim of this study was to evaluate the effect of the Majestro-Frost soft tissue procedure (MFP), which potentially addresses muscle imbalance, on IHR in CP patients during walking.

Methods: A retrospective study of an existing database (medical records and gait laboratory data) was conducted and a search was performed using the following inclusion criteria: (1) diagnosis of spastic CP, (2) GMFCS levels I-III; (3) mean IHR during stance phase higher than 11° at baseline; (4) individuals who received single event multilevel orthopedic surgery in the lower limbs and had three-dimensional gait analyses (3DGA) before and after the intervention.

The increase of anterior pelvic tilt after crouch gait treatment in patients with cerebral palsy.

Background: The increase of anterior pelvic tilt (APT) has been described after the treatment of crouch gait in cerebral palsy (CP). The ideal treatment option for flexed knee gait in CP should provide knee extension improvement in the stance phase without generating the increase of APT.

Research Question: The purpose of this study was to compare three different approaches used for the treatment of crouch gait in CP [distal femur extension osteotomy (DFEO), patellar tendon shortening (PTS) and the combination of DFEO +PTS] regarding the increase of APT after the interventions.

Correlation between physical examination and three-dimensional gait analysis in the assessment of rotational abnormalities in children with cerebral palsy.

Objective To evaluate the correlation between physical examination data concerning hip rotation and tibial torsion with transverse plane kinematics in children with cerebral palsy; and to determine which time points and events of the gait cycle present higher correlation with physical examination findings. Methods A total of 195 children with cerebral palsy seen at two gait laboratories from 2008 and 2016 were included in this study. Physical examination measurements included internal hip rotation, external hip rotation, mid-point hip rotation and the transmalleolar axis angle.

Most frequent gait patterns in diplegic spastic cerebral palsy.

Objective: To identify gait patterns in a large group of children with diplegic cerebral palsy and to characterize each group according to age, Gross Motor Function Classification System (GMFCS) level, Gait Deviation Index (GDI) and previous surgical procedures.

Methods: ONE THOUSAND EIGHT HUNDRED AND FIVE PATIENTS WERE DIVIDED IN SEVEN GROUPS REGARDING OBSERVED GAIT PATTERNS: jump knee, crouch knee, recurvatum knee, stiff knee, asymmetric, mixed and non-classified.

Results: The asymmetric group was the most prevalent (48.

Does the level of proximal femur rotation osteotomy influence the correction results in patients with cerebral palsy?

Proximal femur external rotation osteotomy is a common procedure used for the correction of increased femur anteversion and hip internal rotation in cerebral palsy (CP). Different levels of osteotomy have been used at the proximal femur, but there are no studies in the literature comparing the results in CP. Patients with spastic CP, Gross Motor Function Classification System (GMFCS) I-III, who had undergone a femoral rotational osteotomy from August 1998 to August 2007, and with complete documentation at gait laboratory were included in the study.

Outcomes of correction of internal hip rotation in patients with spastic cerebral palsy using proximal femoral osteotomy.

Internal hip rotation (IHR) is the major cause of intoeing gait in patients with cerebral palsy (CP). Femoral derotation osteotomy (FDO) is the preferred treatment to correct excessive anteversion, however the condition may persist or recur postoperatively. Retrospective clinical and kinematic evaluation of 75 spastic diplegic CP patients was conducted for a mean duration of 22 months following proximal FDO.

The relation of triceps surae surgical lengthening and crouch gait in patients with cerebral palsy.

To investigate the effect of earlier triceps surae (TS) surgical lengthening at knee kinematics in the stance phase in patients with cerebral palsy (CP). One thousand and thirty-nine participants from an eligible total of 1750 children with CP were referred to gait analysis laboratory from January 2000 to April 2007. Inclusion criteria were the diagnosis of diparetic spastic CP levels I to III (GMFCS) and complete kinematics documentation.

Factors associated with pelvic asymmetry in transverse plane during gait in patients with cerebral palsy.

The purpose of this study was to describe the patterns of pelvic rotational asymmetry in the transverse plane and identify the possible factors related to this problem. One thousand and forty-five patients with cerebral palsy (CP) and complete documentation in the gait laboratory were reviewed in a retrospective study. Pelvic asymmetry in the transverse plane was observed in 52.

Idiopathic toe walking: a kinematic and kinetic profile.

Purpose: The differential diagnosis in children who walk on their toes includes mild spastic diplegia and idiopathic toe walking (ITW). A diagnosis of ITW is often one of exclusion. To better characterize the diagnosis of ITW, quantitative gait analysis was utilized in a series of patients with an established diagnosis of ITW.

Are the recommendations from three-dimensional gait analysis associated with better postoperative outcomes in patients with cerebral palsy?

This study was performed to check if recommendations based on three-dimensional gait analysis (3DGA) are associated with better postoperative outcomes in patients with cerebral palsy (CP). Thirty-eight patients who underwent orthopedic surgery and assessment at the Gait Analysis Laboratory were evaluated retrospectively. The patients were divided in four groups according to the agreement between the recommendations from gait analysis and the procedures actually carried out.

Comparison between visual and three-dimensional gait analysis in patients with spastic diplegic cerebral palsy.

Fifty patients with spastic diplegic cerebral palsy were included in this retrospective study which compared visual assessment of gait to three-dimensional (3D) gait analysis. Inter-observer variability was evaluated as well. Inclusion criteria comprehended independent ambulation (i.