Use of quantitative, objective gait analysis for assessment of selection quality of afos in CP children (gait analysis in afos selection in CP)

Małgorzata Syczewska, Anna Święcicka, Małgorzata Kalinowska, Krzysztof Graff

Małgorzata Syczewska, Anna Święcicka, Małgorzata Kalinowska, Krzysztof Graff – Use of quantitative, objective gait analysis for assessment of selection quality of afos in CP children (gait analysis in afos selection in CP). Fizjoterapia Polska 2006; 6(4); 298-303

Abstract
Background. The main aims of clinical gait analysis are to measure and to assess the parameters which characterize the patient’s locomotion in order to identify the primary pathologies and compensatory mechanisms. The aim of this paper is to present 6 patients with CP, in whose case the gait analysis was used to assess the influence of the AFOs on the gait. Material and methods. Six children with cerebral palsy, aged 6 to 14 years old, were recruited into the study. They all were treated in the Dept. Paediatric Rehabilitation CMHI. They underwent the objective gait analysis (using movement analysis system VICON 460) two times: barefoot, and in shoes with AFOs. Results. In four cases AFOs considerably improved the gait pattern, in two patients caused the gait deterioration. Conclusions. The aim of the AFOs is to improve gait (through improved ankle joint stability, and assistance to the weak calf muscles) and to correct pathological deviations, such as knee hyperextension. The improper choice of the AFO type, or bad fitting could result in no improvement, but in more severe cases even in gait deterioration. The results of this paper indicate that the quantitative gait analysis proved to be the efficient tool in assessing the selection quality of AFOs.

Key words:
gait analysis, AFO, CP

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Selective Dorsal Rhizotomy (SDR) – neurosurgical method in treatment of spasticity in CP: the current state of knowledge

Monika Wolska, Marek Kiljański, Witold Rongies

M. Wolska, M. Kiljański, W. Rongies – Selective Dorsal Rhizotomy (SDR) – neurosurgical method in treatment of spasticity in CP: the current state of knowledge. Fizjoterapia Polska 2019; 19(2); 66-75

Abstract
Spasticity constitutes one of the main symptoms of Cerebral Palsy (CP), which has a negative influence on children’s activity, their participation in daily life, and it also impacts their functioning in the society. Chronic spasticity leads to the development of structural lesions in the muscles and in the connective tissue, and it contributes to an intensification of atrophy, rigidity, and finally contractures resistant to pharmacological treatment. Worsening comfort of life and problems with taking care of children with CP constitute other aspects, which justify searching for methods of permanent and effective treatment of spasticity.
The selection of an optimal treatment method for every patient depends on the following: location and extent of the injury, clinical symptoms, patient’s age, and available treatment methods. Selective dorsal rhizotomy (SDR) is a method of surgical treatment of spasticity in children with CP. The procedure is irreversible, and it permanently reduces spasticity. There are still many controversies regarding qualification for the procedure, indications, or short-term and long-term effects. Over the years, there are more and more international clinical studies which confirm the beneficial effect of the procedure in terms of improving the functional state of the patients. The purpose of this paper was to gather and systematize the knowledge about the procedure itself, the qualification criteria, the applied research tools, and the post-surgery physical therapy protocols, as well as to present the effects of surgical treatment.

Key words:
Selective Dorsal Rhizotomy, SDR, physical therapy, spasticity, CP

 

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