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).

An electromyographic protocol that distinguishes spasticity from dystonia.

Purpose: The purpose of this proof of concept study is to demonstrate that electromyographic (EMG) activation patterns of leg muscles differ predictably among patients with predominantly spasticity, patients with predominantly dystonia, and typically developing control subjects during rest, volitional movement, and passively induced movement.

Methods: Eight control subjects, 6 subjects with dystonia, and 7 subjects with spasticity were recruited, ages 6-25 years. Surface EMG sensors were applied over 4 muscle groups of each leg.

Three-dimensional lumbar spine vertebral motion during running using indwelling bone pins.

Study Design: Eight healthy volunteers participated in this observational study.

Objective: Quantify 3-dimensional motions of the lumbar vertebrae during running via direct in vivo measurement and compare these motions to walking data from the same technique and running data from a skin-mounted technique.

Summary Of Background Data: Lumbar spine motions in running are only reported in 1 series of articles using a skin-mounted technique subject to overestimation and only instrumented a single vertebra.

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.

Follow-up motion laboratory analysis for patients with spastic hemiplegia due to cerebral palsy: analysis of the flexor carpi ulnaris firing pattern before and after tendon transfer surgery.

Purpose: To compare the preoperative and postoperative pattern of firing of the flexor carpi ulnaris (FCU) in a grasp and release functional activity for children treated with an FCU to extensor carpi radialis brevis tendon transfer for wrist flexion deformity associated with spastic hemiplegia from cerebral palsy.

Methods: Seven children, evaluated by a preoperative EMG video analysis and treated with an FCU to extensor carpi radialis brevis transfer, had a follow-up postoperative EMG/video motion laboratory analysis at an average follow-up of 3.5 years (range, 1.

Quantitative and qualitative functional evaluation of upper extremity tendon transfers in spastic hemiplegia caused by cerebral palsy.

Background: The purpose of this study was to determine if upper extremity function and joint positioning improved after tendon transfer surgery in patients with spastic hemiplegia caused by cerebral palsy.

Methods: Thirteen patients with spastic hemiplegia underwent tendon transfer surgery at a mean age of 10.8 years (range, 7-24 years).

The in vivo three-dimensional motion of the human lumbar spine during gait.

Lumbar spine pathology accounts for billions of dollars in societal costs each year. Although the symptomatology of these conditions is relatively well understood, the mechanical changes in the spine are not. Previous direct measurements of lumbar spine mechanics have mostly been performed on cadavers.

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.