Retrospective evaluation of changes in gait patterns in children and adolescents with cerebral palsy after multilevel surgery

Steppacher, Ramona; North, David; Künzle, Christoph; Lengnick, Harald; Klima, Harry; Mündermann, Annegret; Wegener, Regina

doi:10.1177/0883073818766681

Publication type:	Article in scientific journal
Type of review:	Peer review (publication)
Title:	Retrospective evaluation of changes in gait patterns in children and adolescents with cerebral palsy after multilevel surgery
Authors:	Steppacher, Ramona North, David Künzle, Christoph Lengnick, Harald Klima, Harry Mündermann, Annegret Wegener, Regina
et. al:	No
DOI:	10.1177/0883073818766681
Published in:	Journal of Child Neurology
Volume(Issue):	33
Issue:	7
Page(s):	453
Pages to:	462
Issue Date:	2018
Publisher / Ed. Institution:	Sage
ISSN:	0883-0738 1708-8283 1702-6075
Language:	English
Subjects:	Cerebral palsy; Gait analysis; Gait deviation; Multilevel surgery; Principal component analysis; Adolescent; Biomechanical phenomena; Cerebral Palsy; Child; Female; Humans; Male; Retrospective study; Single-blind method; Treatment outcome; Young adult; Gait
Subject (DDC):	615.82: Physical therapy 618.92: Pediatrics
Abstract:	The purpose of this study was to retrospectively investigate changes in gait patterns after single-event multilevel surgery in children and adolescents with bilateral cerebral palsy. Three-dimensional instrumented pre- and postoperative gait data of 12 patients were compared to data of 12 healthy control subjects using principal component analysis to reduce the dimensionality of kinematic and kinetic gait data and detect gait differences. The differences between pre- and postoperative data and between postoperative data and data of control subjects were calculated using a linear mixed model. The results revealed 14 significant effects for pre- and postoperative waveforms and 11 significant effects for postoperative and control waveforms. Patients after single-event multilevel surgery walked with smaller internal foot progression angle throughout the gait cycle, lower knee flexion at initial swing, and earlier knee extension during terminal swing. Retained gait deviations included excessive pelvic tilt and internally rotated and flexed hips over the entire gait cycle. Contrary to our hypothesis, postoperative waveforms in the sagittal plane differed more from control waveforms than from preoperative waveforms. These results emphasize the importance of carefully planning further conservative therapy 2 years after single-event multilevel surgery.
URI:	https://digitalcollection.zhaw.ch/handle/11475/28261
Fulltext version:	Published version
License (according to publishing contract):	Licence according to publishing contract
Departement:	School of Health Sciences
Organisational Unit:	Institute of Physiotherapy (IPT)
Appears in collections:	Publikationen Gesundheit

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Steppacher, R., North, D., Künzle, C., Lengnick, H., Klima, H., Mündermann, A., & Wegener, R. (2018). Retrospective evaluation of changes in gait patterns in children and adolescents with cerebral palsy after multilevel surgery. Journal of Child Neurology, 33(7), 453–462. https://doi.org/10.1177/0883073818766681

Steppacher, R. et al. (2018) ‘Retrospective evaluation of changes in gait patterns in children and adolescents with cerebral palsy after multilevel surgery’, Journal of Child Neurology, 33(7), pp. 453–462. Available at: https://doi.org/10.1177/0883073818766681.

R. Steppacher et al., “Retrospective evaluation of changes in gait patterns in children and adolescents with cerebral palsy after multilevel surgery,” Journal of Child Neurology, vol. 33, no. 7, pp. 453–462, 2018, doi: 10.1177/0883073818766681.

STEPPACHER, Ramona, David NORTH, Christoph KÜNZLE, Harald LENGNICK, Harry KLIMA, Annegret MÜNDERMANN und Regina WEGENER, 2018. Retrospective evaluation of changes in gait patterns in children and adolescents with cerebral palsy after multilevel surgery. Journal of Child Neurology. 2018. Bd. 33, Nr. 7, S. 453–462. DOI 10.1177/0883073818766681

Steppacher, Ramona, David North, Christoph Künzle, Harald Lengnick, Harry Klima, Annegret Mündermann, and Regina Wegener. 2018. “Retrospective Evaluation of Changes in Gait Patterns in Children and Adolescents with Cerebral Palsy after Multilevel Surgery.” Journal of Child Neurology 33 (7): 453–62. https://doi.org/10.1177/0883073818766681.

Steppacher, Ramona, et al. “Retrospective Evaluation of Changes in Gait Patterns in Children and Adolescents with Cerebral Palsy after Multilevel Surgery.” Journal of Child Neurology, vol. 33, no. 7, 2018, pp. 453–62, https://doi.org/10.1177/0883073818766681.