Surgical treatment of pes planovalgus in ambulatory children with cerebral palsy: Static and dynamic changes as characterized by multi-segment foot modeling, physical examination and radiographs.

Background: This study employs multi-segment foot modeling (MSFM) to examine flatfoot reconstruction among ambulatory children with cerebral palsy (CP).

Research Question: Does flatfoot reconstruction improve MSFM measures, physical examination and radiographic variables for forefoot varus and midfoot collapse and associated multi-planar compensatory features?

Methods: MSFM was performed preoperatively and postoperatively in a cohort of ambulatory CP patients undergoing flatfoot reconstruction (surgical group, n = 24). A comparison group of non-surgical group of ambulatory CP patients with pes planovalgus (flatfoot) who did not undergo flatfoot reconstruction was also identified (n = 17).

Assessment of three-dimensional lumbar spine vertebral motion during gait with use of indwelling bone pins.

Background: This study quantifies the three-dimensional motion of lumbar vertebrae during gait via direct in vivo measurement with the use of indwelling bone pins with retroreflective markers and motion capture. Two previous studies in which bone pins were used were limited to instrumentation of two vertebrae, and neither evaluated motions during gait. While several imaging-based studies of spinal motion have been reported, the restrictions in measurement volume that are inherent to imaging modalities are not conducive to gait applications.

Measurement and management of errors in quantitative gait data.

Gait analysis is a valuable tool in the evaluation of children and adults with movement disorders. The data produced from gait analysis, however, is not necessarily free of errors. The purpose of this study was two-fold: (i) to estimate the errors associated with quantitative gait data; and (ii) to propose a method for incorporating the knowledge of these errors into the clinical interpretation process.