Orthopaedic Surgery in Dystonic Cerebral Palsy

Blumetti, Francesco Camara; Wu, Janet; Barzi, Federica; Axt, Matthias W.; Waugh, Mary‐Clare; Selber, Paulo

doi:10.1097/bpo.0000000000000919

Cited by 12 publications

(12 citation statements)

References 19 publications

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“…When CGA data are used for planning the operations, early relapses (up to 21 months after surgery) were reported in 15 % of cases. On the contrary, they are 44 % of recurrence in the patients who underwent surgery without performing the CGA [23]. Our results are consistent with the literature.…”

Section: Discussionsupporting

confidence: 92%

Analysis of the causes of pathological patterns of the kinematic locomotor profile based on the findings of computer gait analysis in children with spastic CP types

Chibirov¹,

Долганова²,

Долганов³

et al. 2019

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To interpret the clinical gait analysis (CGA), it is necessary to associate changes in gait with clinical impairment and differentiate the primary deviations in the gait stereotype from compensatory adaptive changes. Purpose To assess the pathological elements of the locomotor profile according to video gait analysis and clinical examination of patients; to compare the abnormalities identified in gait kinematics with the probable clinical causes of these abnormalities. Materials and methods Clinical examination and assessment of the locomotor profile with video gait analysis (CGA) were performed in 46 children (92 limbs) with bilateral spastic types of cerebral palsy (25 boys, 21 girls). We used 6 Qualisys Oqus cameras and one AMTI dynamometric platform (Advanced Mechanical Technology Inc., Watertown, MA, USA) with passive marker video capture technology. The IOR model was used for installing markers. The patterns of the locomotor profile adopted by the Delphic Convention were analyzed. The assessment of diagnostic coincidences or discrepancies was evaluated as percentage rates. Results The portion of the pathological elements of the locomotor profile identified according to the video gait analysis and clinical examination of patients is presented in the tables. The positive ratio of the pathological elements of the locomotor profile identified according to the video gait analysis and clinical examination of patients averaged 66.7 %. The lowest error rate: when assessing the limitation of the range of motion of the ankle joint and hip joint there were 82.6% and 81.8% of positive results, respectively. Discussion Clinical gait analysis (CGA) is crucial in controversial situations regarding detorsion osteotomies in multilevel operations. Conclusions Muscle retraction is the main (primary) clinical sign leading to positional kinematic deviations in joints and segments. The limitation of the range of motion in the knee and ankle joints due to muscle retraction results in secondary contractures of these joints.

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Section: Discussionsupporting

confidence: 92%

Analysis of the causes of pathological patterns of the kinematic locomotor profile based on the findings of computer gait analysis in children with spastic CP types

Chibirov¹,

Долганова²,

Долганов³

et al. 2019

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“…The degree or severity of spasticity in CP varies depending upon the stage of arousal of the child at the time and the duration since the inciting event that lead to spasticity (11,16,(28)(29)(30)(31)(32). Muscle spasticity in a child with CP may interfere with certain functions as well as may serve to facilitate certain functions.…”

Section: Treatment Of Spasticitymentioning

confidence: 99%

“…Muscle spasticity in a child with CP may interfere with certain functions as well as may serve to facilitate certain functions. Therefore, reduction of spasticity should be considered within the context of its functional impact and multiple factors (Table 7) need careful consideration (11,16,(28)(29)(30)(31)(32). Different treatment interventions (Table 8) have been used to treat spasticity in children with CP (11,16,(28)(29)(30)(31)(32).…”

Section: Treatment Of Spasticitymentioning

confidence: 99%

Cerebral palsy in children: a clinical overview

Patel¹,

Neelakantan²,

Pandher³

et al. 2020

Transl Pediatr

313

157

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Cerebral palsy (CP) is a disorder characterized by abnormal tone, posture and movement and clinically classified based on the predominant motor syndrome-spastic hemiplegia, spastic diplegia, spastic quadriplegia, and extrapyramidal or dyskinetic. The incidence of CP is 2-3 per 1,000 live births. Prematurity and low birthweight are important risk factors for CP; however, multiple other factors have been associated with an increased risk for CP, including maternal infections, and multiple gestation. In most cases of CP the initial injury to the brain occurs during early fetal brain development; intracerebral hemorrhage and periventricular leukomalacia are the main pathologic findings found in preterm infants who develop CP. The diagnosis of CP is primarily based on clinical findings. Early diagnosis is possible based on a combination of clinical history, use of standardized neuromotor assessment and findings on magnetic resonance imaging (MRI); however, in most clinical settings CP is more reliably recognized by 2 years of age. MRI scan is indicated to delineate the extent of brain lesions and to identify congenital brain malformations. Genetic tests and tests for inborn errors of metabolism are indicated based on clinical findings to identify specific disorders. Because CP is associatedwith multiple associated and secondary medical conditions, its management requires a multidisciplinary team approach. Most children with CP grow up to be productive adults.

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“…The relationship between biomechanical constraints and neuromuscular systems in patients with cerebral palsy is not clear even if it is crucial knowledge in rehabilitation and surgery ( Blumetti et al, 2019 ; Davids et al, 2019 ). In the simulated toe-walking, crouch, and crouch/equinus gait, Thomas et al (1996) described a decrease in both walking velocity and stride length which correlated with the increase in the number of joints involved.…”

Section: Introductionmentioning

confidence: 99%

Influence of sagittal pelvic attitude on gait pattern in normally developed people and interactions with neurological pathologies: A pilot study

Favetta

Romano

Summa

et al. 2022

Front. Hum. Neurosci.

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BackgroundGait Analysis of healthy people, imitating pathological conditions while walking, has increased our understanding of biomechanical factors. The influence of the pelvis as a biomechanical constraint during gait is not specifically studied. How could mimicking a pelvic attitude influence the dynamic mechanical interaction of the body segments? We proposed an investigation of the pelvic attitude role on the gait pattern of typically developed people when they mimicked pelvic anteversion and posteroversion.Materials and methodsSeventeen healthy volunteers were enrolled in this study (mean age 24.4 ± 5.5). They simulated a pelvic anteversion and posteroversion during walking, exaggerating these postures as much as possible. 3D gait analysis was conducted using an optoelectronic system with eight cameras (Vicon MX, Oxford, United Kingdom) and two force plates (AMTI, Or-6, Watertown, MA, United States). The kinematic, kinetic, and spatio-temporal parameters were compared between the three walking conditions (anteversion, posteroversion, and normal gait).ResultsIn Pelvic Anteversion gait (PA) we found: increased hip flexion (p < 0.0001), increased knee flexion during stance (p = 0.02), and reduction of ankle flexion-extension Range of Motion (RoM) compared with Pelvic Normal gait (PN). In Pelvic Posteroversion gait (PP) compared with PN, we found: decreased hip flexion-extension RoM (p < 0.01) with a tendency to hip extension, decreased knee maximum extension in stance (p = 0.033), and increased ankle maximum dorsiflexion in stance (p = 0.002).ConclusionThe configuration of PA contains gait similarities and differences when compared with pathologic gait where there is an anteversion as seen in children with Cerebral Palsy (CP) or Duchenne Muscular Dystrophy (DMD). Similarly, attitudes of PP have been described in patients with Charcot-Marie-Tooth Syndrome (CMT) or patients who have undergone Pelvic Osteotomy (PO). Understanding the dynamic biomechanical constraints is essential to the assessment of pathological behavior. The central nervous system adapts motor behavior in interaction with body constraints and available resources.

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Orthopaedic Surgery in Dystonic Cerebral Palsy

Abstract: Level IV-this is a case-series.

Cited by 12 publications

References 19 publications

Analysis of the causes of pathological patterns of the kinematic locomotor profile based on the findings of computer gait analysis in children with spastic CP types

Analysis of the causes of pathological patterns of the kinematic locomotor profile based on the findings of computer gait analysis in children with spastic CP types

Cerebral palsy in children: a clinical overview

Influence of sagittal pelvic attitude on gait pattern in normally developed people and interactions with neurological pathologies: A pilot study

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