Parental subjective assessment of gait limitations: Comparison with objective gait variables.

Background: Subjective assessment is an important part of clinical examination providing quality insights into impairments of body structure and functions. Research into the associations between parental perceptions of gait in children with cerebral palsy (CP) and objective clinical gait measures is limited.

Research Question: What are the parental perceived gait limitations in children with CP and are these perceptions associated with objective clinical gait analysis?

Methods: Parent questionnaires were retrospectively analysed for children with CP who attended our gait analysis laboratory over a 24-month period.

Multi-Organ Dysfunction in Cerebral Palsy.

Cerebral Palsy (CP) describes a heterogenous group of non-progressive disorders of posture or movement, causing activity limitation, due to a lesion in the developing brain. CP is an umbrella term for a heterogenous condition and is, therefore, descriptive rather than a diagnosis. Each case requires detailed consideration of etiology.

Factors associated with increased terminal swing knee flexion in cerebral palsy.

Background: Increased terminal swing knee flexion (TSKF) impacts on step length, walking efficiency and may lead to knee flexion in stance in cerebral palsy (CP). Surgical lengthening of the hamstrings is often used to address this issue, but outcomes are inconsistent. There is an established association between TSKF and functional shortening or reduced lengthening velocity of the hamstrings.

Towards development of core domain sets for short term and long term studies of calcium pyrophosphate crystal deposition (CPPD) disease: A framework paper by the OMERACT CPPD working group.

Introduction: Although calcium pyrophosphate deposition (CPPD) is common, there are no published outcome domains or validated measurement instruments for CPPD studies. In this paper, we describe the framework for development of the Outcome Measures in Rheumatology (OMERACT) CPPD Core Domain Sets.

Methods: The OMERACT CPPD working group performed a scoping literature review and qualitative interview study.

Trends in Prevalence and Severity of Pre/Perinatal Cerebral Palsy Among Children Born Preterm From 2004 to 2010: A SCPE Collaboration Study.

To report on prevalence of cerebral palsy (CP), severity rates, and types of brain lesions in children born preterm 2004 to 2010 by gestational age groups. Data from 12 population-based registries of the Surveillance of Cerebral Palsy in Europe network were used. Children with CP were eligible if they were born preterm (<37 weeks of gestational age) between 2004 and 2010, and were at least 4 years at time of registration.

The progression of BMI status over time in Irish ambulant children with cerebral palsy.

Background: An increasing prevalence of overweight and obesity in children has been reported globally. Most studies examining the trajectory of BMI in children over time have tended to focus on children with typical development. Our group previously reported static prevalence rates in children with cerebral palsy.

Experience and impact of crystal pyrophosphate deposition (CPPD) from a patient and caregiver perspective: A qualitative exploration from the OMERACT CPPD working group.

Objective: To explore the lived experience of people with calcium pyrophosphate deposition (CPPD) disease and the impact of this condition on their daily lives.

Methods: Patients with CPPD and their caregivers were invited to take part in a one-to-one (patient only) or paired (patient and caregiver) semi-structured interview. Interviews covered patients' diagnosis and treatment experiences, and the impact of CPPD on their daily lives.

The association between gait analysis measures associated with crouch gait, functional health status and daily activity levels in cerebral palsy.

Purpose: The aim of this study was to examine the relationship between gait analysis measures associated with crouch gait, functional health status and daily activity in ambulant cerebral palsy (CP).

Methods: Three-dimensional gait analysis was carried out on 35 ambulant participants with bilateral CP crouch gait (knee flexion at mid-stance (KFMS) ⩾ 190). KFMS, knee-flexion at initial contact, gait speed and step-lengths were extracted for analysis.

Intrathecal baclofen pumps in the management of hypertonia in childhood: a UK and Ireland wide survey.

Background: Intrathecal baclofen (ITB) is a useful treatment for hypertonia where non-invasive treatments have been ineffective or poorly tolerated. There is an absence of national guidance on selection criteria and a lack of literature regarding patient characteristics and treatment details for children and young people (CYP) receiving ITB therapy in the UK and Ireland. We aimed to gather patient and treatment characteristics for CYP receiving ITB in the UK and Ireland.

The relationship of trunk kinematics and kinetics with lower limb pathology during gait in children with spastic cerebral palsy.

Background: Trunk control during gait in children with cerebral palsy (CP) is known to be impaired. While differentiation of trunk movement between CP subtypes (unilateral/bilateral) has been examined, differentiation of lower lumbar spinal loading has not been considered. Furthermore, the relationship between lower lumbar loading and lower limb pathology has not been reported.

Lower limb biomechanics during gait in children with Achondroplasia.

Achondroplasia is an autosomal dominant disorder that has been reported to be the most common condition associated with severe disproportionate short stature. A limited number of studies exist in the literature reporting kinematic abnormalities in children with Achondroplasia. Reported deviations include increased pelvic tilt, flexed knees during stance and excessive hip abduction.

Outcome domains reported by patients, caregivers, healthcare professionals and stakeholders for calcium pyrophosphate deposition (CPPD): A content analysis based on semi-structured qualitative interviews from the OMERACT CPPD working group.

Introduction: Although calcium pyrophosphate deposition (CPPD) disease is common, there are no validated outcome measures for clinical research in this condition. The aim of this study was to generate a list of outcome domains as reported by patients, their caregivers, healthcare professionals (HCPs) and stakeholders to inform the development of an Outcome Measures in Rheumatology (OMERACT) Core Domain Set for CPPD.

Methods: Patients with CPPD and their caregivers, HCPs and stakeholders took part in semi-structured qualitative interviews to explore potential outcome domains for CPPD clinical research relevant to their lived experience and knowledge of CPPD.

Transition from child to adult health services for young people with cerebral palsy in Ireland: a mixed-methods study protocol.

Introduction: The transition from child to adult health services is a challenging and complex process for young people with cerebral palsy (CP). Poorly managed transition is associated with deterioration in health, increased hospitalisations and reduced quality of life. While international research identifies key practices that can improve the experience and outcomes of transition, there is a paucity of data in the Irish context.

Crouch gait or flexed-knee gait in cerebral palsy: Is there a difference? A systematic review.

Background: Crouch or flexed-knee gait is one of the most common pathological gait patterns in cerebral palsy (CP). Differences exist in definitions used; the degree of knee flexion, inclusion of hip or ankle position, and timing in the gait cycle. This ambiguity may be responsible for variations in prevalence rates and difficulty comparing data across studies.

Centre of pressure error with increasing gait velocity: The clinical impact on predicted inverse dynamics during gait in children with typical development.

Background: Centre of pressure (CoP) location error is common when predicting inverse dynamic parameters during gait. Tolerance levels of error have been previously reported. However, the clinical impact of gait velocity on CoP error has not been considered.

Prevalence of overweight and obesity in Irish ambulant children with cerebral palsy.

Background: Children with cerebral palsy may be at greater risk of being overweight or obese than their typically developed peers due to a number of biomechanical, behavioural, or medical issues that restrict participation. It has been a concern of our multi-disciplinary team that a greater number of children with cerebral palsy were presenting as overweight or obese. However, there are conflicting results in the literature as to prevalence and trends of overweight and obesity in these children.

Outcome domains reported in calcium pyrophosphate deposition studies: A scoping review by the OMERACT CPPD working group.

Introduction: Although calcium pyrophosphate deposition (CPPD) is common, there are no validated outcome domains and/or measurements for CPPD studies. The aim of this work was to identify domains that have been reported in prior clinical studies in CPPD, to inform the development of a core set of domains for CPPD studies.

Methods: We performed a scoping literature review for clinical studies in CPPD, searching in Medline (via PubMed), EMBASE, and Cochrane Central Register of Controlled Trials (CENTRAL) databases; published from January 1, 1946 to January 7, 2020.

A prospective assessment of the progression of flexed-knee gait over repeated gait analyses in the absence of surgical intervention in bilateral cerebral palsy.

Background: Flexed-knee gait is a common pattern associated with cerebral palsy (CP). It leads to excessive forces on the knee and is thought to contribute to pain and deformity. While studies have shown improvements in mid-stance knee flexion following surgery there remains a lack of prospective data on the progression of flexed-knee gait in the absence of surgery.

Tibial rotation outcomes following hamstring lengthening as part of single event multilevel surgery in children with cerebral palsy.

Background: Hamstring lengthening remains the most common surgical procedure in the treatment of crouch gait for children with cerebral palsy (CP). While sagittal plane knee kinematics have been shown to improve post-surgery, the effects on transverse plane kinematics have not been reported. Given the differing actions of the medial and lateral hamstring muscles there is potential for change in tibial rotation post hamstring lengthening.

The Origin of the Cerebral Palsies: Contribution of Population-Based Neuroimaging Data.

Background: Surveillance of cerebral palsy in Europe (SCPE) presents the first population-based results on neuroimaging findings in children with cerebral palsy (CP) using a magnetic resonance imaging classification system (MRICS).

Method: MRIs of children with CP born between 1999 and 2009 from 18 European countries were analyzed. MRICS identifies patterns of brain pathology according to timing during brain development which was analyzed with respect to CP subtypes and gestational age.

Reliability and measurement error of multi-segment trunk kinematics and kinetics during cerebral palsy gait.

Children with cerebral palsy (CP) have been shown to have altered trunk movements during gait resulting in increased loads at the lower lumbar spine. Detailed assessment is possible using 3D gait analysis. However, reliability and quantification of measurement error have not been established.

Dietitians’ Attitudes and Experiences of Blended Tube Feeding in Paediatrics.

Aims To examine; (a) the number of registered dietitians (RDs) with blended tube fed (BTF) patients, work setting and caseload; (b) attitudes and experiences towards BTF; (c) current BTF supports and future resources required. Methods An online survey collected information from Irish RDs over one month. Data was examined using cross-tabulations and Mann-Whitney U tests.

The short-term effects of selective dorsal rhizotomy on gait compared to matched cerebral palsy control groups.

Objectives: To examine the short-term effects of selective dorsal rhizotomy (SDR) ± soft-tissue surgery on gait in cerebral palsy (CP) compared to matched controls with no surgical intervention.

Methods: Participants had gait analysis before and one year after SDR. Non SDR participants were retrospectively matched for age and all significant gait parameters.

The impact of centre of pressure error on predicted joint kinetics during cerebral palsy and typically developed gait: A clinical perspective.

Centre of Pressure (CoP) location error is common when using kinematic and kinetic data to predict intersegmental forces and net joint moments during gait. Changes in peak moments due to CoP error have been reported in the literature. However, debate exists as to what levels of error are acceptable.

Determining the most effective exercise for gluteal muscle activation in children with cerebral palsy using surface electromyography.

Background: Reduced lumbo-pelvic postural control is a common feature of gait in children with Cerebral Palsy (CP). These features are commonly attributed to insufficiency of the hip musculature as well as underlying bony geometry. Exercises aimed at strengthening the hip muscles are frequently prescribed in children with Cerebral Palsy (CP).