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Premature ankle plantarflexor activity during gait: An evaluation of 647 patients with diverse pathologies
ESMAC 2012 abstract / Gait & Posture 38 (2013) S1–S116
Discussion and conclusions: Takken [4] concludes in his review that exercise therapy didn’t show statistically significant effects on functional abilities and therefore claims standardized therapy. PMW is a standardized approach to treat certain deficits in motor abilities of patients with JIA. The results here indicate that PMW shows effects on the JIA patients. The improvement of flexibility and the moderate effect size of the core stability are indicators of further research on this topic. The patients report no detrimental effects due to the intervention. The next steps are to enlarge the sample sizes and to analyze long-term effects. Acknowledgement The authors wish to thank “Kinder-Rheumastiftung” for funding this study. References [1] Singh-Grewal D. Arthritis & Rheumatism 2007;57(7):1202–10. [2] Hartmann M. International Journal of Pediatrics 2010, pii: 835984 (Epub 2010 Sep 2.). [3] Brostrom E. Archives of Physical Medicine and Rehabilitation 2004;85(8):1224–30. [4] Takken T. The Journal of Rheumatology 2002;29(12):2643–7.
http://dx.doi.org/10.1016/j.gaitpost.2013.07.138 P17 Premature ankle plantarflexor activity during gait: An evaluation of 647 patients with diverse pathologies Jacqueline Romkes, Katrin Schweizer, Reinald Brunner University Children’s Hospital Basel, Laboratory for Movement Analysis, Basel, Switzerland Introduction: Premature plantarflexor muscle activity (PPF) during the first 10% of the gait cycle in walking is a common deviation observed in patients with diverse pathologies. Among the aetiological factors are biomechanical alterations and/or muscu-
S63
lar weakness [1,2]. The aim of this study was to evaluate if these factors for PPF are independent of the pathology. Patients/materials and methods: Gait analysis data of 647 patients were investigated retrospectively. Seven pathological groups were defined: orthopaedic uni-/bilateral (OUni/OBi); neurological flaccid uni-/bilateral (NflaUni/NflaBi); neurological spastic uni-/bilateral with/without adequate trunk control (NspUni/NspBi/NspBiNTC). PPF was defined as constant m. gastrocnemius surface EMG activity during 0–10% of gait cycle that exceeded 28%, 23% and 31% of peak activity calculated over the entire gait cycle. The gait profile score (GPS) [3] was calculated as a measure of overall gait deviation. Manual muscle strength (MMS, scale: 0–5 with 5 = normal) of the leg muscle groups [4] was tested and averaged across the muscles to detect muscle weakness. Results: The number of patients with PPF in each group and the subgroups ‘normal MMS’ (≥4.5), ‘reduced MMS’ (<4.5), ‘normal GPS’ (≤7.3◦ ), and ‘abnormal GPS’ (>7.3◦ ) are shown in Fig. 1. PPF is more frequent in patients with reduced MMS/abnormal GPS than in patients with normal MMS/GPS, except for the NflaUni group (may be biased by the small group size). Discussion and conclusions: PPF is an abnormality with clinical relevance, as its prevalence is more than 10% in each patient group. Muscle strength and kinematic deviations both seem to be among the aetiological factors, independent of the pathology. Consequently, PPF should rather be regarded as a secondary deviation than a primary abnormality. Acknowledgement Swiss National Science Foundation (SNF): 32003B 127534.
References [1] [2] [3] [4]
Romkes J, Brunner R. Gait & Posture 2007;26:577–86. Brunner R, Romkes J. Gait & Posture 2008;27:399–407. Baker R, et al. Gait & Posture 2009;30:265–9. Hislop HJ, Montgomery J. Manuelle Muskeltests 1999.
http://dx.doi.org/10.1016/j.gaitpost.2013.07.139 P19 3D gait assessment in children with cerebral palsy using foot-worn inertial sensors Christopher J. Newman 1 , Benoit Mariani 2 , Aline Brégou Bourgeois 3 , Pierre-Yves Zambelli 3 , Kamiar Aminian 2 1 Lausanne University Hospital, Pediatric Neurology and Neurorehabilitation Unit, Lausanne, Switzerland 2 Ecole Polytechnique Fédérale de Lausanne, Laboratory of Movement Analysis and Measurement, Lausanne, Switzerland 3 Lausanne University Hospital, Pediatric Orthopedics and Traumatology Unit, Lausanne, Switzerland
Fig. 1. The figure shows the number of patients with premature plantaflexor activity (PPF) for the seven pathological groups: OUni/OBi: orthopaedic uni-/bilateral; NflaUni/NflaBi: neurological flaccid uni-/bilateral; NspUni/NspBi/NspBiNTC: neurological spastic uni-/bilateral with/without adequate trunk control.
Introduction: Generally, spatio-temporal gait analysis requires dedicated laboratories with complex systems such as optical motion capture. It is likely that a child’s natural gait pattern may be affected by a short distance walkway and the laboratory setting. Recently, ambulatory devices have overcome some of these limitations by using body-worn sensors measuring and analyzing gait kinematics. The aim of this study was to explore the use of foot-worn inertial sensors as a 3D gait measurement tool during a 200-meter walking test in independently walking children with cerebral palsy (CP).
Discussion and conclusions: Takken [4] concludes in his review that exercise therapy didn’t show statistically significant effects on functional abilities and therefore claims standardized therapy. PMW is a standardized approach to treat certain deficits in motor abilities of patients with JIA. The results here indicate that PMW shows effects on the JIA patients. The improvement of flexibility and the moderate effect size of the core stability are indicators of further research on this topic. The patients report no detrimental effects due to the intervention. The next steps are to enlarge the sample sizes and to analyze long-term effects. Acknowledgement The authors wish to thank “Kinder-Rheumastiftung” for funding this study. References [1] Singh-Grewal D. Arthritis & Rheumatism 2007;57(7):1202–10. [2] Hartmann M. International Journal of Pediatrics 2010, pii: 835984 (Epub 2010 Sep 2.). [3] Brostrom E. Archives of Physical Medicine and Rehabilitation 2004;85(8):1224–30. [4] Takken T. The Journal of Rheumatology 2002;29(12):2643–7.
http://dx.doi.org/10.1016/j.gaitpost.2013.07.138 P17 Premature ankle plantarflexor activity during gait: An evaluation of 647 patients with diverse pathologies Jacqueline Romkes, Katrin Schweizer, Reinald Brunner University Children’s Hospital Basel, Laboratory for Movement Analysis, Basel, Switzerland Introduction: Premature plantarflexor muscle activity (PPF) during the first 10% of the gait cycle in walking is a common deviation observed in patients with diverse pathologies. Among the aetiological factors are biomechanical alterations and/or muscu-
S63
lar weakness [1,2]. The aim of this study was to evaluate if these factors for PPF are independent of the pathology. Patients/materials and methods: Gait analysis data of 647 patients were investigated retrospectively. Seven pathological groups were defined: orthopaedic uni-/bilateral (OUni/OBi); neurological flaccid uni-/bilateral (NflaUni/NflaBi); neurological spastic uni-/bilateral with/without adequate trunk control (NspUni/NspBi/NspBiNTC). PPF was defined as constant m. gastrocnemius surface EMG activity during 0–10% of gait cycle that exceeded 28%, 23% and 31% of peak activity calculated over the entire gait cycle. The gait profile score (GPS) [3] was calculated as a measure of overall gait deviation. Manual muscle strength (MMS, scale: 0–5 with 5 = normal) of the leg muscle groups [4] was tested and averaged across the muscles to detect muscle weakness. Results: The number of patients with PPF in each group and the subgroups ‘normal MMS’ (≥4.5), ‘reduced MMS’ (<4.5), ‘normal GPS’ (≤7.3◦ ), and ‘abnormal GPS’ (>7.3◦ ) are shown in Fig. 1. PPF is more frequent in patients with reduced MMS/abnormal GPS than in patients with normal MMS/GPS, except for the NflaUni group (may be biased by the small group size). Discussion and conclusions: PPF is an abnormality with clinical relevance, as its prevalence is more than 10% in each patient group. Muscle strength and kinematic deviations both seem to be among the aetiological factors, independent of the pathology. Consequently, PPF should rather be regarded as a secondary deviation than a primary abnormality. Acknowledgement Swiss National Science Foundation (SNF): 32003B 127534.
References [1] [2] [3] [4]
Romkes J, Brunner R. Gait & Posture 2007;26:577–86. Brunner R, Romkes J. Gait & Posture 2008;27:399–407. Baker R, et al. Gait & Posture 2009;30:265–9. Hislop HJ, Montgomery J. Manuelle Muskeltests 1999.
http://dx.doi.org/10.1016/j.gaitpost.2013.07.139 P19 3D gait assessment in children with cerebral palsy using foot-worn inertial sensors Christopher J. Newman 1 , Benoit Mariani 2 , Aline Brégou Bourgeois 3 , Pierre-Yves Zambelli 3 , Kamiar Aminian 2 1 Lausanne University Hospital, Pediatric Neurology and Neurorehabilitation Unit, Lausanne, Switzerland 2 Ecole Polytechnique Fédérale de Lausanne, Laboratory of Movement Analysis and Measurement, Lausanne, Switzerland 3 Lausanne University Hospital, Pediatric Orthopedics and Traumatology Unit, Lausanne, Switzerland
Fig. 1. The figure shows the number of patients with premature plantaflexor activity (PPF) for the seven pathological groups: OUni/OBi: orthopaedic uni-/bilateral; NflaUni/NflaBi: neurological flaccid uni-/bilateral; NspUni/NspBi/NspBiNTC: neurological spastic uni-/bilateral with/without adequate trunk control.
Introduction: Generally, spatio-temporal gait analysis requires dedicated laboratories with complex systems such as optical motion capture. It is likely that a child’s natural gait pattern may be affected by a short distance walkway and the laboratory setting. Recently, ambulatory devices have overcome some of these limitations by using body-worn sensors measuring and analyzing gait kinematics. The aim of this study was to explore the use of foot-worn inertial sensors as a 3D gait measurement tool during a 200-meter walking test in independently walking children with cerebral palsy (CP).