1st Joint ESMAC-GCMAS Meeting - Análise de Marcha

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surgery group). Post-operatively, peak knee flexion normalized and anterior pelvic tilt decreased by a mean of 4.4 degrees for the TAL Group only (p
O-56 THE EFFECT OF INCLUDING S2 ROOTLETS IN SELECTIVE DORSAL RHIZOTOMY SURGERY Schwartz, Michael H. 1,2 , Trost, Joyce P. 1 , Dunn, Mary E 1,2,3 Krach, Linda E 1,2 , Novacheck, Tom F. 1,2 1 Gillette Children’s Specialty Healthcare, St. Paul, USA 2 University of Minnesota, Minneapolis, USA 3 Shriner’s Hospital for Children - Twin Cities Unit, Minneapolis, USA Summary and Conclusions One and two year outcomes for selective dorsal rhizotomy surgery spanning L1-S1 and L1-S2 rootlets were essentially equivalent. Introduction Selective dorsal rhizotomy (SDR) has been used to reduce tone and increase function in patients with cerebral palsy (CP). Surgical techniques vary, but the typical method involves micro-dissection and electrophysiological testing. One element of the technique that has remained a topic of debate is whether S2 level rootlets should be included. In a study of 85 subjects, Lang found that sparing S2 rootlets leaves “functionally impairing spasticity” in the plantarflexors [1]. Lang’s study did not include quantitative gait measures as part of the outcome. Conversely, Molenaers’ study of 12 subjects suggested that inclusion of S2 rootlets, while producing 1-year outcomes equivalent to the S1 surgery, lead to loss of pelvic tilt, hip extension and knee extension improvements 2 years post-SDR [2]. Molenaers’ study did not report plantarflexor spasticity outcomes. Statement of Clinical Significance It is important to know whether or not S2 rootlets should be included in SDR surgery. Methods Following ethical approval subjects were retrospectively identified as follows: i) gait analysis 0-18 months before SDR (pre), 8-36 months after SDR (post #1), and 6-24 months after post #1 (post #2), ii) SDR at Gillette Children’s Specialty Healthcare or Shriner’s Hospital for Children–Twin Cities. Other clinical patient criteria and surgical details found in prior publications [3]. Groups were created based on whether S2 rootlets had been included (S2) or not (S1). A linear mixed model analysis was used to assess kinematic outcome measures over three time points (pre, post #1, and post #2), while plantarflexor spasticity outcome pre→post #1 was assessed using repeated measures ANOVA (SPSS 13.0.1, SPSS, Inc., Chicago, USA). Results There were 97 subjects with pre and initial follow-up (post #1) data and 27 subjects with subsequent follow-up data (post #2) [Table 1]. Many subjects underwent orthopaedic surgery following post #1, leading to the significant “drop out” rate. All kinematic measures improved pre→post #1 and were unchanged from post #1→post #2, except mean pelvic tilt, which worsened for both groups and both intervals. No differences were found in the response of kinematic variables based on level of SDR (i.e. no pre/pst by S1/S2 interactions); in fact the smallest p-value for an S1 vs. S2 interaction was p = 0.51. Spasticity, as measured by Ashworth score, was reduced equally and significantly for both groups during the pre→post #1 interval (S1: 3.1→1.7, S2: 3.0→1.6). - 184 -
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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
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- 110 - O-28 NORMALCY GAIT INDEX AN
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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 and 106: O-53 EFFECT OF SENSORY-THRESHOLD EL
Page 107 and 108: O-54 THE IMPACT OF SINGLE EVENT MUL
Page 109: O-55 COMPREHENSIVE GAIT ANALYSIS OU
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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