Upper body gait deviations in children with Duchenne muscular dystrophy.

Background: Duchenne muscular dystrophy is primarily a disease of progressive muscle degeneration affecting the whole body. It is important to preserve the patients' walking ability as long as possible. Inconclusive information on Duchenne muscular dystrophy gait pattern is available for the lower body and missing for the upper body.

Group-based progressive functional, high-intensity training in adolescents and young adults with unilateral cerebral palsy - a tool to improve gross motor function, endurance and gait? - a pilot study.

Purpose: This pilot study assessed the safety and effects of progressive functional high-intensity training in a group setting for adolescents with unilateral cerebral palsy (CP) on daily function indicators.

Methods: Nine adolescents (mean age 16.9 years, GMFCS levels I-II) participated in 12 weeks of training (2x/week).

Single procedure tibialis anterior tendon shortening in combination with Achilles tendon lengthening in unilateral cerebral palsy improves swing phase dorsiflexion in gait.

Purpose: Tibialis anterior tendon shortening combined with tendon Achilles lengthening showed satisfactory short- and long-term outcomes for pes equinus treatment. This retrospective study aimed to evaluate the effectiveness of a single tibialis anterior tendon shortening-tendon Achilles lengthening procedure for treating pes equinus, in a homogeneous unilateral cerebral palsy patient group.

Methods: Gait analysis was conducted on 22 unilateral cerebral palsy patients (mean age at surgery = 13.

Kinematic upper limb analysis outperforms electromyography at grading the severity of dystonia in children with cerebral palsy.

Background: Severity of dyskinesia in children with cerebral palsy is often assessed using observation-based clinical tools. Instrumented methods to objectively measure dyskinesia have been proposed to improve assessment accuracy and reliability. Here, we investigated the technique and movement features that were most suitable to objectively measure the severity of dystonia in children with cerebral palsy.

Biomechanical gait parameters change with increasing virtual height in a child with spastic cerebral palsy: A case report.

Virtual height exposure coupled with motion capture is feasible to elicit changes in spatiotemporal, kinematic, and kinetic gait parameters in a child with cerebral palsy and should be considered when investigating gait in real-world-scenarios.

Consequences of Virtual Reality Experience on Biomechanical Gait Parameters in Children with Cerebral Palsy: A Scoping Review.

Virtual reality (VR), coupled with motion tracking, can investigate walking in a controlled setting while applying various walking challenges. The purpose of this review was to summarize the evidence on consequences of VR on biomechanical gait parameters in children with cerebral palsy. MEDLINE, Embase and Web of Science were searched.

Improved Gait and Radiological Measurements After injection of Botulinum Toxin Into Peroneus Longus in Young Children With USCP and Equinovalgus Gait.

Background: Children with cerebral palsy develop foot deformities due to a combination of factors including muscle shortening, hypertonia, weakness, and cocontraction of muscles acting at the ankle joint resulting in an altered gait pattern. We hypothesized these factors affect the peroneus longus (PL) and tibialis anterior (TA) muscles couple in children who develop equinovalgus gait first followed by planovalgus foot deformities. Our aim was to evaluate the effects of abobotulinum toxin A injection to the PL muscle, in a cohort of children with unilateral spastic cerebral palsy and equinovalgus gait.

Reduced plantar-flexors extensibility but improved selective motor control associated with age in young children with unilateral cerebral palsy and equinovalgus gait.

Background: Children with spastic cerebral palsy gradually lose muscle extensibility but the interplay between the muscular and neurological components of the condition is unclear especially in the pathophysiology of equinovalgus gait.

Aim: This study aimed to quantify the muscular and neurological disorders in young children with unilateral cerebral palsy, and to investigate the role of the peroneus longus (PL) in equinovalgus gait.

Design, Setting And Population: This was an observational study with prospective assessments of 31 children (median age: 2.

Torsional deformities and overuse injuries: what does the literature tell us.

Overuse injuries imply the occurrence of a repetitive or an increased load on a specific anatomical segment which is unable to recover from this redundant microtrauma, thus leading to an inflammatory process of tendons, physis, bursa, or bone. Even if the aetiology is controversial, the most accepted is the traumatic one. Limb malalignment has been cited as one of the major risk factors implicated in the development of overuse injuries.

Reliability and sources of variability of 3D kinematics and electromyography measurements to assess newly-acquired gait in toddlers with typical development and unilateral cerebral palsy.

The aim was to 1) determine intersession and intertrial reliability and 2) assess three sources of variability (intersubject, intersession and intertrial) of lower limb kinematic and electromyographic (EMG) variables during gait in toddlers with typical development (TD) and unilateral cerebral palsy (UCP) (age <3 years, independent walking experience ≤6 months). Gait kinematics and surface EMG were recorded in 30 toddlers (19 TD and 11 UCP), during two, 3D-motion capture sessions. Standard error of measurement (SEM) between trials (gait cycles) of the same session and between sessions was calculated to assess reliability.

The impact of symptomatic femoral neck anteversion and tibial torsion on gait, function and participation in children and adolescents.

Background: Torsional deformities of the lower limbs in children and adolescents are a common cause of in-toeing gait and cause gait deviations. The purpose of this study was to examine the relationship of children and adolescents with suspected Idiopathic Torsional Deformities (ITD) and pain, gait function, activity and participation.

Methods: A retrospective review of all children and adolescents who attended our Centre over a 5-year period for evaluation of the effect of ITD.

A Decision Support System to Facilitate Identification of Musculoskeletal Impairments and Propose Recommendations Using Gait Analysis in Children With Cerebral Palsy.

The identification of musculoskeletal impairments from gait analysis in children with cerebral palsy is a complex task, as is formulating (surgical) recommendations. In this paper, we present how we built a decision support system based on gait kinematics, anthropometrics, and physical examination data. The decision support system was trained to learn the association between these data and the list of impairments and recommendations formulated historically by experienced clinicians.

Can pedobarography predict the occurrence of heel rocker in children with lower limb spasticity?

Background: Pedobarography software calculates the centre-of-pressure trajectory in relation to the foot to quantify foot contact patterns. This study presents two new pedobarography measures using the centre-of-pressure trajectory to assess heel rocker.

Methods: To validate these pedobarography measures against 3D gait analysis, emed-x and Vicon Nexus gait analysis data were captured from 25 children aged 8-16 years (11 male) with unilateral (n = 18) and bilateral (n = 7) cerebral palsy or acquired brain injury.

Utilizing three dimensional clinical gait analysis to optimize mobility outcomes in incomplete spinal cord damage.

Background: Three-dimensional gait analysis (3DGA) has not previously been considered by consensus panels of spinal cord experts for use in studies of patients with spinal cord damage (SCD), yet it is frequently used in other neurological populations, such as stroke and cerebral palsy.

Research Question: How does 3DGA impairment based reporting guide individualised clinical decision-making in people with incomplete SCD?

Methods: Retrospective open cohort case series recruited 48 adults with incomplete SCD (traumatic or non-traumatic spinal cord dysfunction) referred to the Clinical Gait Analysis Service (CGAS), Melbourne, Australia. Three-dimensional gait data were used to identify gait impairments by the multidisciplinary clinical team.

Muscle and Joint Function After Anatomic and Reverse Total Shoulder Arthroplasty Using a Modular Shoulder Prosthesis.

Changes in joint architecture and muscle loading resulting from total shoulder arthroplasty (TSA) and reverse total shoulder arthroplasty (RSA) are known to influence joint stability and prosthesis survivorship. This study aimed to measure changes in muscle moment arms, muscle lines of action, as well as muscle and joint loading following TSA and RSA using a metal-backed uncemented modular shoulder prosthesis. Eight cadaveric upper extremities were assessed using a customized testing rig.

Patterns of upper limb muscle activation in children with unilateral spastic cerebral palsy: Variability and detection of deviations.

Background: The aim of this study was two-fold: (1) to quantify the variability of upper limb electromyographic patterns during elbow movements in typically developing children and children with unilateral spastic cerebral palsy, and to compare different amplitude normalization methods; (2) to develop a method using this variability to detect (a) deviations in the patterns of a child with unilateral spastic cerebral palsy from the average patterns of typically developing children, and (b) changes after treatment to reduce muscle activation.

Methods: Twelve typically developing children ([6.7-15.

Rotator cuff contact pressures at the tendon-implant interface after anatomic total shoulder arthroplasty using a metal-backed glenoid component.

Background: Rotator cuff tears following anatomic total shoulder arthroplasty increase with duration of follow-up. This study aimed to evaluate contact pressure between the rotator cuff tendons and prosthesis after anatomic total shoulder arthroplasty and compare these with the tendon-contact pressures in the native shoulder.

Methods: Eight entire upper extremities were mounted onto a testing apparatus, and simulated muscle loading was applied to each rotator cuff tendon with the shoulder positioned in abduction, internal rotation, and external rotation.

Hip- and patellofemoral-joint loading during gait are increased in children with idiopathic torsional deformities.

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.

Computation of hip rotation kinematics retrospectively using functional knee calibration during gait.

Background: Hip rotation kinematics during gait is a key parameter to support clinical decision making, for example in children with lower limb torsional deformities. However, hip rotation kinematics is also one of the least repeatable parameter because it is difficult to locate the position of the medio-lateral axis of the femur. Functional knee calibration provides an alternative to locate the medio-lateral axis of the femur and may be performed retrospectively, using the movement of the knee joint during gait.

Defining the medial-lateral axis of the femur: Medical imaging, conventional and functional calibration methods lead to differences in hip rotation kinematics for children with torsional deformities.

Hip rotation during gait is a major indicator for femoral derotation osteotomy. However, repeatability of hip rotation is poor because of discrepancies in determining the medial-lateral axis of the femur. Combining 3D gait analysis with medical imaging allows in vivo evaluation of current clinical methods.

Long-term development of gait after multilevel surgery in children with cerebral palsy: a multicentre cohort study.

Aim: We investigated the long-term efficacy and safety of multilevel surgery (MLS) in ambulatory children with bilateral spastic cerebral palsy (CP).

Method: Two hundred and thirty-one children were evaluated at short term (1.1y, SD 0.

A model to calculate the progression of the centre of pressure under the foot during gait analysis.

Pedobarography and the centre of pressure (COP) progression is useful to understand foot function. Pedobarography is often unavailable in gait laboratories or completed asynchronously to kinematic and kinetic data collection. This paper presents a model that allows calculation of COP progression synchronously using force plate data.