1st Joint ESMAC-GCMAS Meeting - Análise de Marcha

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group gained voluntary ankle dorsiflexion. Between-group difference of percentage change was not significant (p>0.05). Although walking velocity increased both in the SES (13%) and in the placebo group (13%), the difference between pre- and post-treatment data was not significant. Gait kinematics was improved in both groups but the between-group difference between the groups was not significant. Table 1. Outcome measures in the SES group and the placebo group Pre-treatment Post-treatment Outcome measures SES Placebo SES Placebo BMRS lower extremity 3.2±1.6 3.3±1.2 4.1±1.4 3.5±0.9 Walking velocity (m/s) 0.31±0.1 0.36±0.2 0.34±0.1 0.37±0.2 8 2 1 0 Step length (m) 0.29±0.1 0.28±0.1 0.32±0.1 0.30±0.1 1 6 2 2 % of stance phase (paretic side) 59.1 ± 3.5 58.1 ± 2.5 59.9 ± 4.7 58.8±5.7 Pelvis (°) 11.2±6.7 12.2±3.3 10.0±5.2 11.0±3.1 Hip (°) 15.6±9.6 17.3±10. 0 16.9±7.8 17.7±7.9 Knee (°) 25.4±10. 27.7±14. 27.9±11. 28.1±9.8 2 9 7 Ankle (°) 17.4±13. 7 16.3±4.6 18.5±5.9 16.6±9.9 Maximum ankle DF at swing (°) -6.2±2.3 -5.9±2.4 -4.5±3.1 -5.1±1.3 Maximum ankle PF at initial contact (°) -1.8±0.9 -3.0±1.5 1.2±7.5 -2.1±1.2 Table 2. Percentage change after treatment in the SES group and the placebo group* p
O-54 THE IMPACT OF SINGLE EVENT MULTILEVEL SURGERY(SEMLS) FOR SEVERE CROUCH GAIT IN SPASTIC DIPLEGIC CEREBRAL PALSY: OUTCOME AT FIVE YEARS. Rodda, Jill, Dr 1 , Baker, Richard, Assoc Prof 1,2,3 , Galea, Mary, Prof 2, Nattrass, Gary, Dr 1 , and Graham, H Kerr, Prof 1,2 . 1 Gait CCRE, Murdoch Childrens Research Institute, Royal Children’s Hospital, Melbourne, Australia. 2 The University of Melbourne, Melbourne, Australia. 3 Latrobe University, Melbourne, Australia. Summary/conclusions The natural history of gait in spastic diplegia is for deterioration with time[1-4]. The SEMLS programme aimed to correct severe crouch gait and included the wearing of ground reaction ankle foot orthoses (GRAFOs) and physiotherapy. After the intervention, subjects walked with improved extension at the hip and knee, patellar fractures healed, knee pain was relieved and the acute deterioration in functional mobility was reversed. The improvement in severe crouch gait at one year post intervention was maintained at five years, a significant improvement over the natural history. The surgical prescription did not adequately address the involvement of the hip and pelvis and further study into the effect of psoas lengthening at the hip and pelvis and alternatives to excessive hamstring lengthening for the correction of severe crouch gait should be undertaken. Introduction Severe crouch gait may be associated with severe anterior knee pain, patellar fractures, fatigue and deterioration in gait pattern[5, 6]. These symptoms may lead the child and family to seek treatment. In crouch gait the antigravity muscles are long/weak (soleus, quadriceps and hip extensors), the hip flexors and hamstrings are usually contracted and the bony levers are often malaligned. We devised a program of reconstructive surgery, which consisted of lengthening the contracted muscle tendon units, realigning the bony levers and supporting the new biomechanical alignment with Ground Reaction AFO’s until stable. Statement of clinical significance The long-term outcome of SEMLS on severe crouch gait has not been documented. This study is the first to confirm that improvement post-SEMLS at one year can be maintained at five years post-intervention. Methods This was a retrospective cohort study, conducted in a tertiary paediatric hospital/ gait analysis laboratory. A consecutive sample of 10 children with spastic diplegic cerebral palsy (GMFCS level II-III) in severe crouch gait, were recruited. Severe crouch gait was defined as knee flexion >30 degrees[6, 7] and ankle dorsiflexion >15 degrees throughout stance. SEMLS was based on pre-operative gait analysis. Mean of 7 procedures (range 5-10) were undertaken consisting of lengthening of contracted muscle-tendon units and rotational osteotomies and bony stabilization procedures to correct lever arm dysfunction. During the 1st year post SEMLS, GRAFOs were worn routinely and an individually tailored physiotherapy programme in the community provided. All gait analyses were undertaken barefoot and with usual mobility aids. Post-operative changes were evaluated at one and five years: functional outcome by mobility scales and technical outcomes by 3D kinematics and kinetics, knee radiology and pain scores. Outcomes were analysed with linear regression with robust standard errors. - 180 -
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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
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O-25 3D KINEMATICS OF UPPER EXTREMI
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O-26 CLINICALLY SIGNIFICANT SHOULDE
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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 and 100: O-50 GAIT ANALYSIS IN CHILDREN TREA
Page 101 and 102: O-51 A COMPARISON OF METHODS FOR US
Page 103 and 104: O-52 BIOMECHANICAL OPTIMIZATION OF
Page 105: O-53 EFFECT OF SENSORY-THRESHOLD EL
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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