Manual tracking of muscle fascicle length changes from ultrasound images is a subjective and time-consuming process. The purpose of this study was to assess the repeatability and accuracy of an automated algorithm for tracking fascicle length changes in the medial gastrocnemius (MG) muscle during passive length changes and active contractions (isometric, concentric and eccentric) performed on a dynamometer. The freely available, automated tracking algorithm was based on the Lucas-Kanade optical flow algorithm with an affine optic flow extension, which accounts for image translation, dilation, rotation and shear between consecutive frames of an image sequence. Automated tracking was performed by three experienced assessors, and within- and between-examiner repeatability was computed using the coefficient of multiple determination (CMD). Fascicle tracking data were also compared with manual digitisation of the same image sequences, and the level of agreement between the two methods was calculated using the coefficient of multiple correlation (CMC). The CMDs across all test conditions ranged from 0.50 to 0.93 and were all above 0.98 when recomputed after the systematic error due to the estimate of the initial fascicle length on the first ultrasound frame was removed from the individual fascicle length waveforms. The automated and manual tracking approaches produced similar fascicle length waveforms, with an overall CMC of 0.88, which improved to 0.94 when the initial length offset was removed. Overall results indicate that the automated fascicle tracking algorithm was a repeatable, accurate and time-efficient method for estimating fascicle length changes of the MG muscle in controlled passive and active conditions.

Combined functional anaerobic and strength training increased muscle size, strength, and functional capacity in young adults with cerebral palsy. The addition of anaerobic training to progressive resistance training programs assists in the transfer to improved functional capacity.

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The purpose of this study was to systematically review the current literature to determine the effect of a femoral derotation osteotomy (FDRO) on hip and pelvic rotation kinematics during gait compared to no intervention in children with spastic cerebral palsy (CP). We performed a systematic search for prospective and retrospective cohort studies of children with CP, who were treated with a FDRO, and were assessed with pre and post surgery three-dimensional gait analysis. Medline, CINAHL, EMBASE, the Cochrane Library and Web of Science were searched up to December 2013. Data sources were prospective and retrospective studies. Mean differences were calculated on pooled data for both pelvic and hip rotation kinematics. Thirteen of 196 articles met the inclusion criteria (5 prospective, 8 retrospective). All included studies were of sufficient quality for meta-analysis as assessed using a customised version of the STROBE checklist. Meta-analysis showed that FDRO significantly reduced pelvic retraction by 9.0 degrees and hip internal rotation by 17.6 degrees in participants with unilateral CP involvement and hip internal rotation by 14.3 degrees in participants with bilateral CP involvement. Pelvic symmetry in children with unilateral spastic CP is significantly improved by FDRO. Patients with bilateral involvement do not improve their transverse plane pelvic rotation profiles during gait as a result to FDRO, although this result should be interpreted with caution due to the heterogeneous nature of these participants and of the methods used in the studies assessed.