1st Joint ESMAC-GCMAS Meeting - Análise de Marcha

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groups also appeared to increase their hip flexion moment to compensate for reductions about the knee. Discussion This study presents the first attempt to compare knee biomechanics during walking and landing between the two most commonly used graft types for ACL reconstruction and an activity matched control group. The most notable difference between the groups was seen in the moments about the knee. The patellar tendon group had a reduced external knee flexion moment at mid stance in gait and during single limb landing. The hamstring group had a reduced external extension moment at terminal stance. As the principle difference between the groups appeared to be the graft itself, these biomechanical changes may result from the effects of graft harvest. There is some evidence to suggest that reduced knee flexion interferes with the normal ability of the knee to absorb shock [6], and may lead to early degenerative joint changes. If this is the case, the patellar tendon patients would be expected to be at greater risk of this. Clearly further long term studies are required to explore the relationship between knee biomechanics and osteoarthritis. This is an area worthy of future research as both graft types are currently used for ACL reconstruction to allow patients to return to sporting activities. References 1. Bush-Joseph, C.A., et al., Dynamic function after anterior cruciate ligament reconstruction with autologous patellar tendon. American Journal of Sports Medicine, 2001. 29(1): p. 36-41. 2. Devita, P., T. Hortobagyi, and J. Barrier, Gait biomechanics are not normal after anterior cruciate ligament reconstruction and accelerated rehabilitation. Med Sci Sports Exerc, 1998. 30(10): p. 1481-8. 3. Ferber, R., et al., Gait mechanics in chronic ACL deficiency and subsequent repair. Clin Biomech, 2002. 17(4): p. 274-85. 4. Georgoulis, A., et al., Three-dimensional tibiofemoral kinematics of the anterior cruciate ligament-deficient and reconstructed knee during walking. Am J Sports Med, 2003. 31(1): p. 75-9. 5. Noyes, F.R., et al., The anterior cruciate ligament-deficient knee with varus alignment. An analysis of gait adaptations and dynamic joint loadings. Am J Sports Med, 1992. 20(6): p. 707-16. 6. Cook, T., et al., Effects of restricted knee flexion and walking speed on the vertical ground reaction force during gait. J Orthop Sports Phys Ther., 1997. 25(4): p. 236-44. - 187 -
O-58 RECOVERY OF MUSCLE STRENGTH FOLLOWING MULTI-LEVEL ORTHOPAEDIC SURGERY IN DIPLEGIC CEREBRAL PALSY Seniorou Maria, MD, Thompson Nicky, MSc, MCSP, Theologis Tim, FRCS Oxford Gait Laboratory, Nuffield Orthopaedic Centre, Oxford, UK Summary/conclusions This study was undertaken to establish the length of muscle strength recovery following multilevel orthopaedic surgery in diplegic cerebral palsy. We demonstrated that the majority of lower limb muscle groups are weaker than pre-operatively at 1 year from operation, despite intensive physiotherapy. Introduction We have previously shown that children with cerebral palsy are weak and at 6 months post multilevel surgery there is a significant reduction in both muscle strength and motor function, despite significant improvements in gait at this stage. Following intensive physiotherapy focusing on muscle strengthening at 6 months post-op, partial recovery of muscle strength was observed [1]. The aim of the present study was to assess the continuing recovery of muscle strength by following-up patients to 1 year post-surgery. Statement of Clinical Significance Surgical techniques and post-operative physiotherapy regimes following multi-level surgery should improve further in order to preserve and improve muscle strength. Methods Twenty children with spastic diplegia who underwent single-stage multi-level surgery (mean age at surgery 12.5 years, GMFCS level I-III) were matched for age, sex and functional level and randomised to two groups. Both groups immediately commenced routine post-operative physiotherapy, and at 6 months post-op additional strength training regimes were administered three times weekly for six weeks. Group A (n=11) undertook a progressive resistance training regime using weights and Group B (n=9) an active exercise regime against gravity only. A control group of 10 children with cerebral palsy/spastic diplegia (GMFCS levels I-II, mean age 11 years) were also recruited for comparison. Gait (Vicon 612 system), isometric muscle strength (hip flexors, hip extensors, hip abductors, knee flexors, and knee extensors at 90° and 30° of flexion, MIE digital dynamometer) and motor function (GMFM-88) were assessed in both groups pre-operatively, at 6 months post-operatively prior to strength training, and immediately after strength training. The same measurements were repeated at 12 months. Within group comparisons were analysed using paired sample t-tests. Differences between the two groups were evaluated using analysis of co-variance. P=0.05 was considered the level of significance. Results In the control group, no changes in muscle strength were observed at 6 or 12 months. The GMFM showed trends towards deterioration without reaching statistical significance. Sagittal kinematics and some kinetic parameters showed significant deterioration at 1 year post-baseline. In both surgical groups, significant decrease of strength was observed post-surgery and partial improvement following physiotherapy at 6 months. Strength improved further at 1 year post-op but did not reach pre-op values, with the exception of hip abductors and knee extensors at 30° (Table 1). No significant difference was observed between the two surgical groups undergoing different physiotherapy regimes. - 188 -
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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
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O-30 GAITABASE: NEW APPROACH TO CLI
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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 and 110: O-55 COMPREHENSIVE GAIT ANALYSIS OU
Page 111 and 112: O-56 THE EFFECT OF INCLUDING S2 ROO
Page 113: O-57 DYNAMIC FUNCTION AFTER ANTERIO
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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