Can on-line gait training improve clinical practice? Study protocol for feasibility randomised controlled trial of an on-line educational intervention to improve clinician's gait-related decision-making in ambulant children and young people with cerebral palsy.

Background: Instrumented gait analysis (IGA) is an assessment and research tool with proven impacts on clinical decision-making for the management of ambulant children and young people with cerebral palsy (CYPwCP) but is underused and variably understood by relevant clinicians. Clinicians' difficulties in gaining expertise and confidence in using IGA are multifactorial and related to access for clinical decision-making, limited training opportunities and inability to translate this training into clinical practice.

Methods: The primary aim of this study is to test the feasibility of an educational intervention to advance clinicians' application of gait analysis in CYPwCP, to inform a definitive trial.

Acceptability of a progressive resistance training programme for ambulatory adolescents with spastic cerebral palsy in England: a qualitative study.

Purpose: The aim of this study was to explore the acceptability of a 10-week progressive resistance training programme from the perspective of ambulatory adolescents with CP and physiotherapists.

Material And Methods: Semi-structured interviews were conducted with 32 adolescents with spastic CP, aged 10-19 years in Gross Motor Function Classification System (GMFCS) levels I-III, and 13 physiotherapists. Adolescents had completed a 10-week progressive resistance training programme and physiotherapists had delivered the programme.

The impact of instrumented gait analysis on decision-making in the interprofessional management of cerebral palsy: A scoping review.

Background: Management of gait-related problems in children and young people with Cerebral Palsy (CYPwCP) is complex and requires an interprofessional approach. Irrespective of underlying mechanisms, instrumented gait analysis (IGA) can provide quantification of gait to support clinical decision-making for CYPwCP when planning treatment interventions.

Aim: This scoping review aimed to determine the impact of instrumented gait analysis (IGA) on treatment decision-making for CYPwCP, paying particular attention to interprofessional decision-making.

Clinicians' Experiences of Instrumented Gait Analysis in Management of Patients with Cerebral Palsy: A Qualitative Study.

Aim: To identify the interaction of instrumented gait analysis (IGA) training, expertise, and application in gait-related management of cerebral palsy.

Methods: Semi-structured interviews with 20 purposively sampled clinicians with varying professional backgrounds, expertise, and training, analyzed using the framework method.

Results: Fifteen sub-themes were identified within three domains: training, equipment/outputs, and roles/reasons under the core theme IGA practice.

Understanding skeletal muscle in cerebral palsy: a path to personalized medicine?

Until recently, there has been little interest in understanding the intrinsic features associated with the pathomorphology of skeletal muscle in cerebral palsy (CP). Coupled with emerging evidence that challenges the role of spasticity as a determinant of gross motor function and in the development of fixed muscle contractures, it has become increasingly important to further elucidate the underlying mechanisms responsible for muscle alterations in CP. This knowledge can help clinicians to understand and apply treatment modalities that take these aspects into account.

Acquisition and loss of best walking skills in children and young people with bilateral cerebral palsy.

Aim: To explore factors predicting acquisition and loss of best walking ability in young people with bilateral cerebral palsy (CP).

Method: In our population cohort (Study of Hips And Physical Experience) of 338 children (201 males, 137 females) with bilateral CP, age at achieving walking was recorded and walking ability predicted from early motor milestones. Walking was assessed at 5 to 8 years (mean 7y) and in 228 of 278 survivors at 13 to 19 years (mean 16y).

Does delayed onset muscle soreness affect the biomechanical variables of the drop vertical jump that have been associated with increased ACL injury risk? A randomised control trial.

Introduction: Delayed onset muscle soreness (DOMS) and Anterior Cruciate Ligament (ACL) injuries are both prevalent in sport. It is currently unknown whether DOMS increases ACL injury risk.

Aim: This study aimed to provide preliminary insight on whether DOMS affects ACL injury risk by investigating whether DOMS affects the biomechanical variables of the DVJ that have been identified as risk factors for future ACL injury.

3D ultrasound to quantify lateral hip displacement in children with cerebral palsy: a validation study.

Aim: To assess the validity of a new index, lateral head coverage (LHC), for describing hip dysplasia in a population of children with cerebral palsy (CP).

Method: LHC is derived from 3D ultrasound assessment. Twenty-two children (15 males, seven females; age 4-15y) with CP undergoing routine hip surveillance were recruited prospectively for the study.

Progressive resistance training for adolescents with cerebral palsy: the STAR randomized controlled trial.

Aim: To evaluate the effect of progressive resistance training of the ankle plantarflexors on gait efficiency, activity, and participation in adolescents with cerebral palsy (CP).

Method: Sixty-four adolescents (10-19y; 27 females, 37 males; Gross Motor Function Classification System [GMFCS] levels I-III) were randomized to 30 sessions of resistance training (10 supervised and 20 unsupervised home sessions) over 10 weeks or usual care. The primary outcome was gait efficiency indicated by net nondimensional oxygen cost (NNcost).

Validity of the International Physical Activity Questionnaire Short Form (IPAQ-SF) as a measure of physical activity (PA) in young people with cerebral palsy: A cross-sectional study.

Objectives: The aim of this study was to examine the validity of the International Physical Activity Questionnaire Short Form (IPAQ-SF) as a measure of physical activity (PA) in young people with cerebral palsy (CP).

Design: Cross-sectional.

Setting: Participants were recruited through 8 National Health Service (NHS) trusts, one school, one university and through organisations that provide services for people with disabilities in England.

Investigating the impact of measurement uncertainty in the radiographic surveillance of hip displacement in cerebral palsy: A Monte Carlo simulation.

Hip surveillance programmes have greatly improved the management of hip dysplasia in children with cerebral palsy. Reimer's migration percentage is the most common index for quantifying hip dysplasia from planar radiographs. However, measurement uncertainty could undermine the diagnostic accuracy.

Predictors of Walking Efficiency in Children With Cerebral Palsy: Lower-Body Joint Angles, Moments, and Power.

Background: People with cerebral palsy (CP) experience increased muscle stiffness, muscle weakness, and reduced joint range of motion. This can lead to an abnormal pattern of gait, which can increase the energy cost of walking and contribute to reduced participation in physical activity.

Objective: The aim of the study was to examine associations between lower-body joint angles, moments, power, and walking efficiency in adolescents with CP.

Factors associated with pain in adolescents with bilateral cerebral palsy.

Aim: We explored factors associated with pain and its severity in a population cohort of young people with bilateral cerebral palsy, comparing parent/carer and young people self-reports.

Method: Of 278 survivors (mean age 16y 8mo, SD 1y 4mo, range 13y 8mo-19y 3mo) from the South Thames in the Study of Hips and Physical Experience cohort of 338 young people with bilateral cerebral palsy, 212 parents/carers and 153 young people completed questionnaires on the presence, severity, timing, site, associated factors, impact, and treatment of pain.

Results: Seventy per cent of parents/carers reported pain within 3 months, 59% the previous week, and 50% the previous day with 56% reporting 'regularly experienced'.

Selective motor control and gross motor function in bilateral spastic cerebral palsy.

Aim: To investigate the relationship between selective motor control (SMC), muscle volume, and spasticity with gross motor function in adolescents and young adults with bilateral spastic cerebral palsy (CP).

Method: Eleven male participants with CP (mean age 15y 7mo, standard deviation 3y 6mo, range 12y 1mo-23y 1mo) in Gross Motor Function Classification System (GMFCS) levels I to IV took part in this cross-sectional study. Magnetic resonance imaging (MRI) of both lower limbs of all participants were acquired, from which 18 muscles were manually segmented and muscle volume calculated by a single assessor.

Author Correction: Reliability and feasibility of gait initiation centre-of-pressure excursions using a Wii Balance Board in older adults at risk of falling.

In the original publication, the article title was incorrectly published as 'Reliability and feasibility of gait initiation centre-of-pressure excursions using a Wii® Balance Board in older adults at risk of failing'. The correct title should read as 'Reliability and feasibility of gait initiation centre-of-pressure excursions using a Wii® Balance Board in older adults at risk of falling'.

Reliability and feasibility of gait initiation centre-of-pressure excursions using a Wii Balance Board in older adults at risk of falling.

Background: Impairments in dynamic balance have a detrimental effect in older adults at risk of falls (OARF). Gait initiation (GI) is a challenging transitional movement. Centre of pressure (COP) excursions using force plates have been used to measure GI performance.

Comparison of standing postural control and gait parameters in people with and without chronic low back pain: a cross-sectional case-control study.

Objective: Differences in postural control and gait have been identified between people with and without chronic low back pain (CLBP); however, many previous studies present data from small samples, or have used methodologies with questionable reliability. This study, employing robust methodology, hypothesised that there would be a difference in postural control, and spatiotemporal parameters of gait in people with CLBP compared with asymptomatic individuals.

Methods: This cross-sectional case-control study age-matched and gender-matched 16 CLBP and 16 asymptomatic participants.

The relationship between lower limb muscle volume and body mass in ambulant individuals with bilateral cerebral palsy.

Background: Individuals with cerebral palsy have smaller muscle volumes normalised to body mass than their typically developing peers. The aim of this study is to investigate the relationship between lower limb muscle volume and body mass in young people with bilateral cerebral palsy and their typically developing peers.

Methods: Twenty-five participants with bilateral cerebral palsy (aged 14.

A practical clinical kinematic model for the upper limbs.

A novel clinically practical upper limb model is introduced that has been developed through clinical use in children and adults with neurological conditions to guide surgery to the elbow and wrist. This model has a minimal marker set, minimal virtual markers, and no functional joint centres to minimise the demands on the patient and duration of data collection. The model calculates forearm supination independently from the humerus segment, eliminating any errors introduced by poor modelling of the shoulder joint centre.

Lower limb muscle volume estimation from maximum cross-sectional area and muscle length in cerebral palsy and typically developing individuals.

Background: Deficits in muscle volume may be a significant contributor to physical disability in young people with cerebral palsy. However, 3D measurements of muscle volume using MRI or 3D ultrasound may be difficult to make routinely in the clinic. We wished to establish whether accurate estimates of muscle volume could be made from a combination of anatomical cross-sectional area and length measurements in samples of typically developing young people and young people with bilateral cerebral palsy.

High-resolution X-ray diffraction with no sample preparation.

It is shown that energy-dispersive X-ray diffraction (EDXRD) implemented in a back-reflection geometry is extremely insensitive to sample morphology and positioning even in a high-resolution configuration. This technique allows high-quality X-ray diffraction analysis of samples that have not been prepared and is therefore completely non-destructive. The experimental technique was implemented on beamline B18 at the Diamond Light Source synchrotron in Oxfordshire, UK.