1st Joint ESMAC-GCMAS Meeting - Análise de Marcha

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Normal gait was present in both 13% of Ponseti and PT feet. Discussion Although gait deviations were still seen in this study, results are superior to those of operated clubfeet. [9] PT feet had a tendency toward less DF and increased internal rotation. The sagittal plane findings have led our center and others to adopt early release of the gastrocsoleus. We now anticipate better ankle motion in future patients. Internal rotation was also more frequent in the PT group, likely because the Ponseti group uses a nighttime abduction bar until age 3 yrs. The importance of increased DF seen in some Ponseti feet remains uncertain. Whether this is a predecessor to calcaneus gait, or whether ankle range of motion will diminish with time is unknown. D e g r e e s DF PF 40 20 0 -20 -40 Gait Cycle (%) References 1. Karol LA, Concha MC, Johnston CE. (1997), J Pediatr Orthop, Vol 17, pp. 790-5. 2. 2.Deformity and disability from treated clubfoot. Aronson J, Puskarich CL.(1990). J Pediatr Orthop, Vol. 10, pp. 109-119. 3. Davies, TC, Kiefer G, Zernicke RF. (2001), J Pediatr Orthop, Vol. 21: 335-371. 4. Richards BS, Johnston CE, Wilson H. (2005), J Pediatr Orthop, Vol 25, pp. 98-102. 5. Bensahel H, Guillaume A, Czukonyi Z, et al. (1990), J Pediatr Orthop, Vol 10, pp. 189-192. 6. Dimeglio A, Bonnet F, Mazeau P, et al., (1996), J Pediatr Orthop (B), Vol 5, pp. 173-180. 7. Treatment of congenital club foot. Ponseti IV. (1992), J Bone Joint Surg (Am), (1992), Vol.74, pp. 448-454. 8. Dimeglio A, Bensahel H, Souchet P, et al. (1995), J Pediatr Orthop (B), Vol. 4, pp. 129-136. 9. Karol LA, O’Brien SE, Wilson H, et al. (2005), J Pediatr Orthop, Vol 25, pp. 236-240. - 171 - Sagittal-plane ankle kinematic data over one complete gait cycle for both treatment groups: Ponseti casted (solid) and French physical therapy (dashed). Positive values represent dorsiflexion and negative values represent plantarflexion. Shaded regions represent one standard deviation above and below the average age-matched normal data.
O-51 A COMPARISON OF METHODS FOR USING CENTER OF PRESSURE PROGRESSION IN THE CLASSIFICATION OF FOOT DEFORMITY Gene Jameson, MA, Jason Anderson, MS, Roy Davis, Ph.D., Jon Davids, MD, and Lisa Christopher, BS Shriners Hospitals for Children, Greenville, SC, USA Introduction The pedobarograph, a system that measures plantar pressure, has been successfully applied to patients with neuropathy where the information can be used to prevent pressure-related problems 1,2 . In attempts to utilize the pedobarograph in the evaluation of children with cerebral palsy and associated foot deformities, previous researchers used normalized plantar pressure within different regions of the foot to classify the feet into varus or valgus categories 3,4 . One recent method of pedobarograph analysis used the normal center of pressure progression (COPP) during stance to establish medio-lateral divisions of the foot 5 . The COPP for pathological feet could then be compared to COPP from a normal population. This method required the longitudinal axis of the foot to be subjectively determined by the analyst so the pedobabrograph output could be oriented consistently and comparisons made. The current study expands on that method by introducing simultaneous motion capture to evaluate the difference between subjective and objective methods of long axis determination. Statement of Clinical Significance This study reports a new pedobarograph analysis procedure as well as the results for a population of pediatric individuals without gait impairment and compares it to previously published data. This information can then be used in the evaluation and treatment of patients with foot deformity. Methods Five successful walking trials were collected for each foot of 23 normal subjects (mean age 11.4 ± 3.3 years, range of 6 to 17 years). One representative trial was selected for each foot for COPP analysis. Because the ultimate goal was to apply this technique to feet with pathology, the custom software developed in our laboratory allows for the analysis of the COPP if the foot shape is atypical and if the entire foot does not make contact with the floor surface. A graphical computer interface allowed the four analysts to specify the long axis of each foot, which was defined as a line connecting a point between the second and third metatarsal and the midpoint of the heel. The medial and lateral borders of the foot were also identified. In addition to this analysis, the 3D kinematic data was used to identify foot landmarks consistent with standard gait analysis, i.e. medial and lateral malleoli, and the midline of the foot at the base of the toes. The center point between the malleoli markers and the toe marker established the long axis of the foot. The length of the foot was divided into three regions longitudinally (Figure 1). One and two standard deviations from the mean COPP were calculated (Figure 1). These fore/aft and medio-lateral regions were numbered to facilitate classification (Figure 1). The time (% of stance) and location of the COP within the heel, midfoot and forefoot regions were determined so that the COPP could be described temporally as well as in both anteroposterior and mediolateral directions (Figure 2). The rotation angles of the long axis as determined by the two methods was compared, as well as the rotation angles between the four observers. Results The average COPP in normal individuals begins in the middle of the heel region at initial contact then progresses forward for 23.8% of stance phase. It proceeds forward through the - 172 -
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O-01 KNEE EXTENSION AT TERMINAL SWI
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O-02 THE MODIFIED TARDIEU IN STANDI
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O-03 COORDINATION BETWEEN PELVIS, T
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O-04 CAN GAIT ANALYSIS GUIDE MANAGE
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O-05 DISTAL FEMORAL EXTENTSION OSTE
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O-06 THE EFFECT OF SHOES ON GAIT IN
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O-07 CORRELATIONS BETWEEN CLINICAL
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O-08 DOUBLE CALIBRATION VS GLOBAL O
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O-09 THE SYMMETRICAL AXIS OF ROTATI
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O-10 FEASIBILITY OF A NEW -JOINT CO
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O-11 A SINGLE GAIT CYCLE AS MEASURE
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O-12 IMPROVED TRACKING OF HIP ROTAT
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O-13 PROTOCOL CHANGES CAN IMPROVE T
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O-14 ALTERNATIVE METHODS FOR MEASUR
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O-15 OVERLAY PROJECTION OF 3D GAIT
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O-16 RELATIONSHIP BETWEEN THE ANTHR
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O-17 COMPARING THE RELIABILITY OF V
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O-18 3D HIP AND PELVIC GAIT PATTERN
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O-19 RELIABILITY AND VALIDITY OF AN
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O-20 HOW ACCURATE IS THE ESTIMATION
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O-21 IMPACT OF WHEELCHAIR PROPULSIO
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O-22 TOWARDS A NEW PROTOCOL FOR MOT
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O-23 KINEMATIC ANALYSIS OF UPPER LI
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O-24 KINEMATIC UPPER LIMB ANALYSIS
Page 49 and 50: O-25 3D KINEMATICS OF UPPER EXTREMI
Page 51 and 52: O-26 CLINICALLY SIGNIFICANT SHOULDE
Page 53 and 54: O-27 OBJECTIVE IDENTIFCATION OF GAI
Page 55 and 56: - 110 - O-28 NORMALCY GAIT INDEX AN
Page 57 and 58: O-29 GILLETTE GAIT INDEX IS CONSIST
Page 59 and 60: O-30 GAITABASE: NEW APPROACH TO CLI
Page 61 and 62: O-31 A MODIFIED GAIT CLASSIFICATION
Page 63 and 64: O-32 QUANTIFICATION OF KINEMATIC ME
Page 65 and 66: O-33 EXTRINSIC AND INTRINSIC VARIAT
Page 67 and 68: O-34 PAIRED OUTCOME ASSESSMENT OF A
Page 69 and 70: O-35 ENERGY EXPENDITURE DURING OVER
Page 71 and 72: O-36 HIGH FAILURE RATES WHEN AVOIDI
Page 73 and 74: O-37 SUBJECT SPECIFIC HIP GEOMETRY
Page 75 and 76: O-38 BIOMECHANICAL AND METABOLIC PE
Page 77 and 78: O-39 BIOMECHANICS OF GAIT IN CHARCO
Page 79 and 80: O-40 SAGITTAL PLANE LOWER EXTREMITY
Page 81 and 82: O-41 AN EXPLORATION OF THE FUNCTION
Page 83 and 84: O-42 DYNAMIC SIMULATIONS OF SLOW, F
Page 85 and 86: O-43 AUTOMATIC IDENTIFICATION OF MU
Page 87 and 88: O-44 DYNAMIC MEASUREMENT OF GASTROC
Page 89 and 90: O-45 ASSESSING THE REGULATORY ACTIV
Page 91 and 92: O-46 ABNORMAL EMG-ACTIVITY IN PATHO
Page 93 and 94: O-47 AVERAGED EMG PROFILES IN RUNNI
Page 95 and 96: O-48 TRACKING DYNAMIC FOOT PRESSURE
Page 97 and 98: O-49 THE INFLUENCE OF FOOTWEAR SOLE
Page 99: O-50 GAIT ANALYSIS IN CHILDREN TREA
Page 103 and 104: O-52 BIOMECHANICAL OPTIMIZATION OF
Page 105 and 106: O-53 EFFECT OF SENSORY-THRESHOLD EL
Page 107 and 108: O-54 THE IMPACT OF SINGLE EVENT MUL
Page 109 and 110: O-55 COMPREHENSIVE GAIT ANALYSIS OU
Page 111 and 112: O-56 THE EFFECT OF INCLUDING S2 ROO
Page 113 and 114: O-57 DYNAMIC FUNCTION AFTER ANTERIO
Page 115 and 116: O-58 RECOVERY OF MUSCLE STRENGTH FO
Page 117 and 118: O-59 AUDITORY-PACED WALKING FOLLOWI
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1st Joint ESMAC-GCMAS Meeting - Análise de Marcha

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