Foot and Knee Behaviour During Gait in Response to the Use of Additional Means of Treatment in Celebral Palsied Children

Czupryna, Krzysztof; Nowotny, Janusz

doi:10.5604/15093492.1005088

Cited by 5 publications

(3 citation statements)

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“…A number of studies have demonstrated the benefits of BoNT-A injection for dynamic equinus foot in patients with CP. 1 2 13 14 15 19 34 35 However, previous studies on the effects of such an injection for dynamic equinovarus foot have rarely addressed children with CP. For dynamic equinovarus foot, TP and calf muscles are the target muscles for BoNT-A injection.…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies using computerized gait analysis after BoNT-A injection for equinus foot in children with CP revealed several significant changes in ankle kinematic data and kinetic data. 8 10 11 12 13 14 15 Although used as a gold standard for planning and assessing the outcome of corrective musculoskeletal surgery in CP patients, the computerized gait analysis system has limited ability to reveal significant changes in foot deformities in the frontal plane such as valgus and varus deformities after therapeutic intervention. 16 17 …”

Section: Introductionmentioning

confidence: 99%

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Botulinum Toxin Type A Injection for Spastic Equinovarus Foot in Children with Spastic Cerebral Palsy: Effects on Gait and Foot Pressure Distribution

et al. 2016

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PurposeTo investigate the effect of intramuscular Botulinum toxin type A (BoNT-A) injection on gait and dynamic foot pressure distribution in children with spastic cerebral palsy (CP) with dynamic equinovarus foot.Materials and MethodsTwenty-five legs of 25 children with CP were investigated in this study. BoNT-A was injected into the gastrocnemius (GCM) and tibialis posterior (TP) muscles under the guidance of ultrasonography. The effects of the toxin were clinically assessed using the modified Ashworth scale (MAS) and modified Tardieu scale (MTS), and a computerized gait analysis and dynamic foot pressure measurements using the F-scan system were also performed before injection and at 1 and 4 months after injection.ResultsSpasticity of the ankle plantar-flexor in both the MAS and MTS was significantly reduced at both 1 and 4 months after injection. On dynamic foot pressure measurements, the center of pressure index and coronal index, which represent the asymmetrical weight-bearing of the medial and lateral columns of the foot, significantly improved at both 1 and 4 months after injection. The dynamic foot pressure index, total contact area, contact length and hind foot contact width all increased at 1 month after injection, suggesting better heel contact. Ankle kinematic data were significantly improved at both 1 and 4 months after injection, and ankle power generation was significantly increased at 4 months after injection compared to baseline data.ConclusionUsing a computerized gait analysis and foot scan, this study revealed significant benefits of BoNT-A injection into the GCM and TP muscles for dynamic equinovarus foot in children with spastic CP.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Botulinum Toxin Type A Injection for Spastic Equinovarus Foot in Children with Spastic Cerebral Palsy: Effects on Gait and Foot Pressure Distribution

et al. 2016

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“…The current knowledge on the topic demonstrates that the number of muscle synergies is lower in CP than in healthy subjects and it decreases when the GMCSF level increases ( Kim et al, 2021 ). The most affected synergies are those related to the knee-foot and the knee-hip couples, which result to be impaired in most patients ( Thelen et al, 2003 ; Czupryna and Nowotny, 2012 ). In addition, children affected by CP show a higher stride-to-stride variability, which is not observed in healthy controls ( Kim et al, 2018 ; Yu et al, 2019 ; Bekius et al, 2021 ).…”

Section: Introductionmentioning

confidence: 99%

Recent developments in muscle synergy analysis in young people with neurodevelopmental diseases: A Systematic Review

Beltrame

Scano

Marino

et al. 2023

Front. Bioeng. Biotechnol.

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The central nervous system simplifies motor control by sending motor commands activating groups of muscles, known as synergies. Physiological locomotion can be described as a coordinated recruitment of four to five muscle synergies. The first studies on muscle synergies in patients affected by neurological diseases were on stroke survivors. They showed that synergies can be used as biomarkers for motor impairment as they vary in patients with respect to healthy people. Likewise, muscle synergy analysis has been applied to developmental diseases (DD). The need for a comprehensive view of the present findings is crucial for comparing results achieved so far and promote future directions in the field. In the present review, we screened three scientific databases and selected thirty-six papers investigating muscle synergies extracted from locomotion in children affected by DD. Thirty-one articles investigate how cerebral palsy (CP) influences motor control, the currently exploited method in studying motor control in CP and finally the effects of treatments in these patients in terms of synergies and biomechanics; two articles investigate how muscle synergies vary in Duchenne muscular dystrophy (DMD), and three other articles assess other developmental pathologies, such as chronic and acute neuropathic pain. For CP, most of the studies demonstrate that the number of synergies is lower and that the synergy composition varies in the affected children with respect to normal controls. Still, the predictability of treatment’s effects and the etiology of muscle synergy variation are open questions, as it has been reported that treatments minimally modify synergies, even if they improve biomechanics. The application of different algorithms in extracting synergies might bring about more subtle differences. Considering DMD, no correlation was found between non-neural muscle weakness and muscle modules’ variation, while in chronic pain a decreased number of synergies was observed as a possible consequence of plastic adaptations. Even if the potential of the synergistic approach for clinical and rehabilitation practices is recognized, there is not full consensus on protocols nor widely accepted guidelines for the systematic clinical adoption of the method in DD. We critically commented on the current findings, on the methodological issues and the relative open points, and on the clinical impact of muscle synergies in neurodevelopmental diseases to fill the gap for applying the method in clinical practice.

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Walking Patterns of Normal Men

Charalambous

2013

Classic Papers in Orthopaedics

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Foot and Knee Behaviour During Gait in Response to the Use of Additional Means of Treatment in Celebral Palsied Children

Cited by 5 publications

References 0 publications

Botulinum Toxin Type A Injection for Spastic Equinovarus Foot in Children with Spastic Cerebral Palsy: Effects on Gait and Foot Pressure Distribution

Botulinum Toxin Type A Injection for Spastic Equinovarus Foot in Children with Spastic Cerebral Palsy: Effects on Gait and Foot Pressure Distribution

Recent developments in muscle synergy analysis in young people with neurodevelopmental diseases: A Systematic Review

Walking Patterns of Normal Men

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