- Email: [email protected]
P028 Withdrawn
S66
Abstracts of the 17th Annual Meeting of ESMAC, Poster Presentations / Gait & Posture 28S (2008) S49–S118
pathological pes plano valgus declined to 56% after measuring the plantar pressure distribution (PPD). It seems that PPD can help the children to protect them from unnecessary treatment. Introduction: The PPD of children at different ages during walking is quite well documented in literature [1]. Despite this there exists no study showing the relevance of the dynamic information of the PPD in the every day clinical setting by children with PPV. Therefore the aim of this study is to apply the measurement of PPD in the clinical diagnostic of PPV and compare this to PPD-data of a control group without pathological findings. The hypothesis is that diagnostic findings can be adjudged and discussed more objectively and help to optimize the therapy. Patients/Materials and Methods: The plantar pressure distribution of 169 children between 3 and 14 years with no history of foot disability was analyzed as control group. We used the first step method to collect the data of the right foot with an EMEDSF platform. For the identification of the PPV the contact area, peak pressure, peak force under the midfoot as well as the arch index were analyzed. The defined parameters were depicted as 3%-, 50%- and 97%-percentiles depending on children’s age (e.g. Figures 1, 2). Up to now 16 patients’ feet with different age and degree of severity were analyzed and compared with the control data.
Results: The peak pressure of the patients under the midfoot was located to 75% (Figure 1), peak force to 44%, arch index to 44% (Figure 2) and contact area to 50% in the percentile curves of the parameters of the control group. The PPD of 7 “problematic” feet were located in the normal range in all analyzed parameters. Discussion: The results of the “patients” show that there is a trend of over diagnosis in children with PPV in comparison to the results of the data of the control group. In future individual longitudinal analysis from clinical borderline cases will make a retrospective consideration of the development of the feet of individual children possible. By the use of this methodological approach we want to see if parameters from the PPD can distinguish between a physiological and pathological development of childrens’ feet at an early stage. The PPD will continue to be applied in older children to optimize therapy. References [1] Bosch K, Gerss J, Rosenbaum D. (2007). Preliminary normative values for foot loading parameters of the developing child. Gait Posture 26(2): 238−47.
P028 Withdrawn P029 Diagnostic usage of combined biomechanical gait and running-analysis V. Metzler1 , G. Treff2 , L. D¨oderlein3 . 1 Gaitlab, Treatment Center Aschau im Chiemgau; 2 Section of Sports and Rehabilitation Medicine, University of Ulm; 3 Orthopaedic Clinic, Treatment Center Aschau im Chiemgau, Germany
Figure 1. Percentile curves and patients’ data of Peak Pressure.
Figure 2. Percentile curves and patients’ data of arch index.
Summary: The aim of the study is to test the hypothesis that the instrumental running analysis (IR) allows recognition of motor deficits and incorrect load that instrumental gait analysis (IG) does not show or not clear. Conclusions: In combination with the patient histories, proves the combined IG+IR quite important to opimize diagnostic and therapy. Introduction: For many years the IG is used as an investigation modality to plan surgery, to optimise therapy and to control care in orthopaedic and neurological clinics. It is also used for clarification of conspicuous gait patterns and painful conditions of unclear etiology. A combination of gait- and running analysis predicts a better diagnosis of motor abnormalities and pathological stresses. This is because the higher torque demand during running led to higher demands on the musculoskeletal system and claims the neuromuscular abilities in a more complex way. Patients/Materials and Methods: 12 children (12.5±4.3 yrs, 34.3±22.4 kg, 1.47±0.22 m) with walking and running abilities and different clinical histories participated in the study. They walked (1.25±0.12 m/s) and ran (2.68±0.13 m/s) at selfselected speeds which were the same as the control group (CG). The CG comprised of 20 healthy children (14±1.5 yrs, 54.2±9.0 kg, 1.67±0.09 m). Kinetic and kinematic data were captured by the Vicon-Motion-System. Joint angles, moments and the mechanical power were calculated with the NewingtonModel [1,2]. 28 discrete parameters were analysed to evaluate the Norm-deviation-index [NAI = (mw pat − mw norm) /sd norm.).
Abstracts of the 17th Annual Meeting of ESMAC, Poster Presentations / Gait & Posture 28S (2008) S49–S118
pathological pes plano valgus declined to 56% after measuring the plantar pressure distribution (PPD). It seems that PPD can help the children to protect them from unnecessary treatment. Introduction: The PPD of children at different ages during walking is quite well documented in literature [1]. Despite this there exists no study showing the relevance of the dynamic information of the PPD in the every day clinical setting by children with PPV. Therefore the aim of this study is to apply the measurement of PPD in the clinical diagnostic of PPV and compare this to PPD-data of a control group without pathological findings. The hypothesis is that diagnostic findings can be adjudged and discussed more objectively and help to optimize the therapy. Patients/Materials and Methods: The plantar pressure distribution of 169 children between 3 and 14 years with no history of foot disability was analyzed as control group. We used the first step method to collect the data of the right foot with an EMEDSF platform. For the identification of the PPV the contact area, peak pressure, peak force under the midfoot as well as the arch index were analyzed. The defined parameters were depicted as 3%-, 50%- and 97%-percentiles depending on children’s age (e.g. Figures 1, 2). Up to now 16 patients’ feet with different age and degree of severity were analyzed and compared with the control data.
Results: The peak pressure of the patients under the midfoot was located to 75% (Figure 1), peak force to 44%, arch index to 44% (Figure 2) and contact area to 50% in the percentile curves of the parameters of the control group. The PPD of 7 “problematic” feet were located in the normal range in all analyzed parameters. Discussion: The results of the “patients” show that there is a trend of over diagnosis in children with PPV in comparison to the results of the data of the control group. In future individual longitudinal analysis from clinical borderline cases will make a retrospective consideration of the development of the feet of individual children possible. By the use of this methodological approach we want to see if parameters from the PPD can distinguish between a physiological and pathological development of childrens’ feet at an early stage. The PPD will continue to be applied in older children to optimize therapy. References [1] Bosch K, Gerss J, Rosenbaum D. (2007). Preliminary normative values for foot loading parameters of the developing child. Gait Posture 26(2): 238−47.
P028 Withdrawn P029 Diagnostic usage of combined biomechanical gait and running-analysis V. Metzler1 , G. Treff2 , L. D¨oderlein3 . 1 Gaitlab, Treatment Center Aschau im Chiemgau; 2 Section of Sports and Rehabilitation Medicine, University of Ulm; 3 Orthopaedic Clinic, Treatment Center Aschau im Chiemgau, Germany
Figure 1. Percentile curves and patients’ data of Peak Pressure.
Figure 2. Percentile curves and patients’ data of arch index.
Summary: The aim of the study is to test the hypothesis that the instrumental running analysis (IR) allows recognition of motor deficits and incorrect load that instrumental gait analysis (IG) does not show or not clear. Conclusions: In combination with the patient histories, proves the combined IG+IR quite important to opimize diagnostic and therapy. Introduction: For many years the IG is used as an investigation modality to plan surgery, to optimise therapy and to control care in orthopaedic and neurological clinics. It is also used for clarification of conspicuous gait patterns and painful conditions of unclear etiology. A combination of gait- and running analysis predicts a better diagnosis of motor abnormalities and pathological stresses. This is because the higher torque demand during running led to higher demands on the musculoskeletal system and claims the neuromuscular abilities in a more complex way. Patients/Materials and Methods: 12 children (12.5±4.3 yrs, 34.3±22.4 kg, 1.47±0.22 m) with walking and running abilities and different clinical histories participated in the study. They walked (1.25±0.12 m/s) and ran (2.68±0.13 m/s) at selfselected speeds which were the same as the control group (CG). The CG comprised of 20 healthy children (14±1.5 yrs, 54.2±9.0 kg, 1.67±0.09 m). Kinetic and kinematic data were captured by the Vicon-Motion-System. Joint angles, moments and the mechanical power were calculated with the NewingtonModel [1,2]. 28 discrete parameters were analysed to evaluate the Norm-deviation-index [NAI = (mw pat − mw norm) /sd norm.).