Prolongatión of Walking in Duchenne Muscular Dystrophy With Lightweight Orthoses; Review of 57 Cases

Heckmatt, J. Z.; Dubowitz, Victor; Hyde, Stephanie; John, F.; Gabain, A.; Thompson, N.

doi:10.1111/j.1469-8749.1985.tb03763.x

Cited by 71 publications

(14 citation statements)

References 10 publications

(7 reference statements)

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“…26 Gordon et al 27 concluded that percutaneous lengthening of the medial hamstrings was a useful option in ambulant children with CP undergoing a variety of concomitant operations. They reported significantly Table III.…”

Section: Discussionmentioning

confidence: 99%

The use of minimally invasive techniques in multi-level surgery for children with cerebral palsy

Thompson

Stebbins

Seniorou

et al. 2010

The Journal of Bone and Joint Surgery. British volume

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This study compares the initial outcomes of minimally invasive techniques for single-event multi-level surgery with conventional single-event multi-level surgery. The minimally invasive techniques included derotation osteotomies using closed corticotomy and fixation with titanium elastic nails and percutaneous lengthening of muscles where possible. A prospective cohort study of two matched groups was undertaken. Ten children with diplegic cerebral palsy with a mean age of ten years six months (7.11 to 13.9) had multi-level minimally invasive surgery and were matched for ambulatory level and compared with ten children with a mean age of 11 years four months (7.9 to 14.4) who had conventional single-event multi-level surgery. Gait kinematics, the Gillette Gait Index, isometric muscle strength and gross motor function were assessed before and 12 months after operation. The minimally invasive group had significantly reduced operation time and blood loss with a significantly improved time to mobilisation. There were no complications intra-operatively or during hospitalisation in either group. There was significant improvement in gait kinematics and the Gillette Gait Index in both groups with no difference between them. There was a trend to improved muscle strength in the multi-level group. There was no significant difference in gross motor function between the groups. We consider that minimally invasive single-event multi-level surgery can be achieved safely and effectively with significant advantages over conventional techniques in children with diplegic cerebral palsy.

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Section: Discussionmentioning

confidence: 99%

The use of minimally invasive techniques in multi-level surgery for children with cerebral palsy

Thompson

Stebbins

Seniorou

et al. 2010

The Journal of Bone and Joint Surgery. British volume

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“…There are some experts who feel the use of KAFO’s prolongs ambulation in DMD by one to three years. 45, 46 Although the literature to support this is poor, 47 the greater reason why fewer patients are using KAFO bracng in recent years is due to the efficacy of corticosteroids in prolonging ambulation. In addition, the compliance of DMD patients with KAFO bracing is variable.…”

Section: Management Of Contracturesmentioning

confidence: 99%

Prevention and Management of Limb Contractures in Neuromuscular Diseases

Skalsky

McDonald

2012

Physical Medicine and Rehabilitation Clinics of North America

126

101

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Synopsis Limb contractures are a common impairment in neuromuscular diseases (NMD). They contribute to increased disability due to decreased motor performance, mobility limitations, reduced functional range of motion, loss of function for activities of daily living (ADL), and increased pain. The pathogenesis of contractures is multifactorial. Myopathic conditions are associated with more severe limb contractures in comparison to neuropathic disorders. Although the evidence supporting the efficacy of multiple interventions to improve ROM in NMD in a sustained manner is lacking, there are generally accepted principles with regard to splinting, bracing, stretching, and surgery that help minimize the impact or disability from the contractures.

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“…Rehabilitation in knee-ankle-foot orthoses (KAFOs) is offered to boys with DMD at the end of independent ambulation, and is effective in prolonging walking for an average of 18 months to 2 years 12. The technique entails custom-built KAFOs, and in the past used to require surgical release of the Achilles tendon to reduce ankle contracture and allow fitting of the KAFO, and is generally well tolerated 13.…”

Section: Physiotherapy and Orthosesmentioning

confidence: 99%

Update on the management of Duchenne muscular dystrophy

Manzur

Kinali²,

Muntoni³

2008

Archives of Disease in Childhood

139

105

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Duchenne muscular dystrophy (DMD) is familiar to paediatricians as the most common childhood muscular dystrophy and leads to severe disability and early death in the late teenage years if untreated. Improvements in general care, glucocorticoid corticosteroid treatment, non-invasive ventilatory support, and cardiomyopathy and scoliosis management have significantly changed the course of DMD in treated individuals, so that survival into adulthood is now a realistic possibility for most patients. This has important implications for the medical and social sectors involved in the transition to adult medical services and the provision of suitable employment and social care. Multidisciplinary team working for optimal management of DMD-specific multisystem complications is essential, and collaboration in disease specific national clinical networks is recommended. Several curative therapeutic strategies including cell and gene therapy are being pursued but are still at an experimental stage.

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Prolongatión of Walking in Duchenne Muscular Dystrophy With Lightweight Orthoses; Review of 57 Cases

Cited by 71 publications

References 10 publications

The use of minimally invasive techniques in multi-level surgery for children with cerebral palsy

The use of minimally invasive techniques in multi-level surgery for children with cerebral palsy

Prevention and Management of Limb Contractures in Neuromuscular Diseases

Update on the management of Duchenne muscular dystrophy

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