| 41. |
- Bartonek, A., et al.
(författare)
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The influence of spasticity in the lower limb muscles on gait pattern in children with sacral to mid-lumbar myelomeningocele : a gait analysis study
- 2005
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Ingår i: Gait & Posture. - : Elsevier BV. - 0966-6362 .- 1879-2219. ; 22:1, s. 10-25
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Tidskriftsartikel (refereegranskat)abstract
- Gait analysis and recording of standing position were performed in 38 ambulatory children with myelomeningocele. Thirty-four were independent ambulators and four required a walking aid. All subjects were assigned one of four muscle function groups based on muscle strength. They were also divided into subgroups based on the distinction between flaccid and spastic paresis in the lower limb joints. A comparison was made between the gait pattern of the children with spasticity and that of the children with flaccid paresis in each muscle function group. Spasticity in only the ankle joint muscles influenced the subject's gait and standing position compared to the subgroups with a flaccid paresis. Even larger deviations in gait and standing position were observed when spasticity occurred in muscles at the knee and hip joints. When setting ambulatory goals the presence of additional neurological symptoms such as spasticity and inadequate balance should be taken into consideration.
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| 42. |
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| 43. |
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| 44. |
- Danielsson, AJ, et al.
(författare)
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Associations between orthopaedic findings, ambulation and health-related quality of life in children with myelomeningocele
- 2008
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Ingår i: Journal of children's orthopaedics. - : SAGE Publications. - 1863-2521 .- 1863-2548. ; 2:1, s. 45-54
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Tidskriftsartikel (refereegranskat)abstract
- Modern principles for treatment of patients with myelomeningocele include early closure of the neural tube defect, neurosurgical treatment of hydrocephalus and treatment aimed at minimizing contractures and joint dislocations. The aim is to achieve a better survival rate and a better quality of life (QOL). Better ambulatory function is thought to improve the management of activities of daily living. This study focused on evaluating which factors might affect ambulation, function and health-related QOL in children with myelomeningocele. Methods Thirty-eight patients with neurological deficit from myelomeningocele were examined in an unbiased follow-up. This included a physical examination using validated methods for ambulatory function and neuromuscular status, chart reviews and evaluation of radiographs in terms of hip dislocation and spine deformity. The Pediatric Evaluation of Disability Inventory (PEDI) was used to measure mobility, self-care and social function, and the Child Health Questionnaire (CHQ-PF50) was used to measure QOL. Results Muscle function class, quadriceps strength, spasticity in hip and/or knee joint muscles and hip flexion contracture as well as the ambulatory level all affected functional mobility as well as self-care/PEDI. Patients with hip dislocation, spinal deformity or those who were mentally retarded also had significantly worse functional mobility. Besides being affected by the severity of the neurological lesion, self-care/PEDI was significantly impaired by hip flexion contracture and absence of functional ambulation. General health-related QOL was significantly lower in this patient group than for US norms. Nonambulatory and mentally retarded patients had a significantly lower physical function of their QOL (CHQ). Conclusions The severity of the disease, i.e. reduced muscle strength and occurrence of spasticity around hip/knee, affected ambulation, functional mobility and self-care. Acquired deformities (hip dislocation and spine deformity) affected functional ambulation only. Patients with reduced functional mobility and self-care experienced lower physical QOL. Children with myelomeningocele had significantly reduced QOL compared to healthy individuals.
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| 45. |
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| 46. |
- Duraj, F, et al.
(författare)
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Tarmtransplantation
- 1998
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Ingår i: Läkartidningen. ; 28, s. 3172-
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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| 47. |
- Gutierrez-Farewik, Elena M., et al.
(författare)
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Centre of mass motion during gait in persons with myelomeningocele
- 2003
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Ingår i: Gait & Posture. - 0966-6362 .- 1879-2219. ; 18:2, s. 37-46
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Tidskriftsartikel (refereegranskat)abstract
- The movement of the centre of mass in the vertical and lateral directions during gait in children with myelomeningocele was analyzed. The children were classified into five groups depending on the successive paresis of lower limb muscle groups and compared to a control group. In the groups with. dorsi- and plantarflexor weakness, the excursions increased and an anterior trend in the centre of mass was observed. In the groups with additional abductor paresis, the lateral excursion was highest and the vertical excursion low due to increased transverse and frontal motion and reduced sagittal motion. With further paresis of the hip extensors, the centre of mass was more posteriorly positioned due to compensatory trunk extension. Improved understanding of individual children's solutions to their muscle paresis can be obtained by visualizing the centre of mass relative to the pelvis. Centre of mass analyses in myelomeningocele offer an important complement to standard gait analysis.
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| 48. |
- Gutierrez-Farewik, Elena M., et al.
(författare)
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Characteristic gait kinematics in persons with lumbosacral myelomeningocele
- 2003
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Ingår i: Gait & Posture. - 0966-6362 .- 1879-2219. ; 18:3, s. 170-177
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Tidskriftsartikel (refereegranskat)abstract
- Thirty self-ambulatory children with mid-lumbar to low-sacral myelomeningocele who walked without aids and 21 control children were evaluated by three-dimensional gait analysis. Characteristic kinematic patterns and parameters in the trunk, pelvis, hip, knee and ankle were analyzed with respect to groups with successive weakness of the ankle plantarflexor, ankle dorsiflexor, hip abductor, hip extensor and knee flexor muscles. Extensive weakness of the plantarflexors resulted in kinematic alterations in the trunk, pelvis, hip and knee and in all three planes seen as knee flexion, anterior pelvic tilt and trunk and pelvic rotation. Additional extensive weakness of the dorsiflexors made little difference in the walking strategy. Large kinematic alterations in all planes were observed where there was a large extent of additional weakness of the hip abductor but strength remaining in the hip extensors. In this group, gait was characterized by large lateral sway of the trunk, rotation of the trunk and pelvis, pelvic hike and increased extension of the knees. In the group with total poresis hip extensors but yet some knee flexion, gait was similar to the previous group but there was less sagittal plane movement greates and posterior trunk tilt. Gait analysis provides an understanding of the compensatory strategies employed in these patients. Clinical management can be directed towards stabilizing the lower extremities and accommodating large upper body motion to preserve this method of self-ambulation even in children who have considerable hip extensor and abductor weakness.
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| 49. |
- Gutierrez-Farewik, Elena M., et al.
(författare)
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Comparison and evaluation of two common methods to measure center of mass displacement in three dimensions during gait
- 2006
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Ingår i: Human Movement Science. - : Elsevier BV. - 0167-9457 .- 1872-7646. ; 25:2, s. 238-256
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Tidskriftsartikel (refereegranskat)abstract
- Center of mass displacement during gait has frequently been used as an indicator of gait efficiency or as a complement to standard gait analysis. With technological advances, measuring the center of mass as the centroid of a multi-segment system is practical and feasible, but must first be compared to the well-established Newtonian computation of double-integrating the ground reaction force. This study aims to verify that the kinematic centroid obtained from a commonly-used model (Vicon Peak (R) Plug-In-Gait) provides at least as reliable measurements of center of mass displacement as those obtained from the ground reaction forces. Gait data was collected for able-bodied children and children with myelomeningocele who use larger lateral center of mass excursions during gait. Reasonable agreement between methods was found in fore-aft and vertical directions, where the methods' excursions differed by an average of less than 10 mm in either direction, and the average RMS differences between methods' computed curves were 6 and 13 mm. Particularly good agreement was observed in the lateral direction, where the calculated excursions differed by an average of less than 2 mm and the RMS difference was 5 mm. Error analyses in computing the center of mass displacement from ground reaction forces were performed. A 5% deviation in mass estimation increased the computed vertical excursion twofold, and a 5% deviation in the integration constant of initial velocity increased the computed fore-aft excursions by 10%. The suitability of calculating center of mass displacement using ground reaction forces in a patient population is questioned. The kinematic centroid is susceptible to errors in segment parameters and marker placement, but results in plausible results that are at least within the range of doubt of the better-established ground reaction force integration, and are more useful when interpreting 3-D gait data.
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| 50. |
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