Article

The aim of this study was to determine if gait analysis improves correction
of excessive hip internal rotation in ambulatory children with spastic cerebral
palsy (CP). METHOD: Children undergoing orthopedic surgery were randomized to
receive or not receive a preoperative gait analysis report. This secondary
analysis included all participants whose gait report recommended external femoral
derotation osteotomy (FDRO). One-year postoperative,
and pre- to postoperative
change in femoral anteversion, mean hip rotation in stance, and mean foot
progression in stance were compared between groups and in subgroups based on
whether the recommendation for FDRO was followed. RESULTS: Outcomes did not
differ between the group which received a gait report (n=39; 19 males, 20
females; mean age 10y 4mo [SD 3y]; hemiplegia, 3; di/triplegia, 28; quadriplegia,
8; Gross Motor Function Classification System [GMFCS]: level I, 5; level II, 12;
level III 19; level IV, 3) and the control group (n=26; 14 males, 12 females;
mean age 9y 5mo [SD 2y 10mo]; hemiplegia, 1; di/triplegia, 21; quadriplegia, 4;
GMFCS: level I, 4; level II, 1; level III, 9; level IV, 2; all p values >0.29),
but improved more in the gait report subgroup in which the FDRO recommendation
was followed (seven limbs; change in anteversion -32.9 degrees , hip rotation
-25.5 degrees , foot progression -36.2 degrees ) than in the control group
(anteversion -12.2 degrees ,
hip rotation -7.6 degrees , foot progression -12.4
degrees ; all p values </=0.02) and the gait report subgroup in which FDRO was
not performed (32 limbs; anteversion -1.0 degrees ,
hip rotation 0.5 degrees ,
foot progression -8.0 degrees ; all p values </=0.003). Postoperative measures
became normal only in the gait report subgroup in which the recommended FDRO was
performed. INTERPRETATION: Gait analysis can improve outcomes when its
recommendations are incorporated in the treatment plan.
CI - (c) 2013 Mac Keith Press.

Langue : ANGLAIS