Use of 3D gait analysis as predictor of achilles tendon lengthening surgery outcomes in children with cerebral palsy

European Journal of Physical and Rehabilitation Medicine
Giuseppina PilloniManuela Galli

Abstract

In children with spastic Cerebral Palsy (CP), the treatment of equinus foot with Achilles tendon lengthening (ATL) surgery is associated with high incidence of overcorrection, which may result in crouch gait. We aimed to assess if gait pattern in preoperative time could be a predictor of the surgery outcome. Cross-sectional retrospective study. Movement Analysis Lab, IRCCS San Raffaele Pisana Hospital, Rome (ITALY). Eighteen children (mean age 9.64.7 years) with spastic diplegia CP who underwent bilateral ATL surgery to correct equinus foot were involved. Participants underwent 3D gait analysis before and approximately 12 months after surgery. Primary measures were spatiotemporal, kinematic (summarized by Gait Variable Scores, GVSs) and kinetic parameters. The gait patterns for each leg was defined from kinematic data, using a quantitative classification: Plantar Flexor Knee Extension (PFKE) index. The CP group was split into true equinus and jump gait. The equinus foot was successfully corrected as demonstrated by the improvement of GVS ankle dorsi-plantarflexion. However, there was a high rate of overcorrection in the true equinus, characterized by increases in knee flexion- extension GVS (8.7° pre vs. 16.7° post P<0.05) and...Continue Reading

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