Article

Previous studies examining the influence of gait analysis on surgical
decision-making have been limited by the lack of a control group. The aim of this
study was to use data from a randomized controlled trial to determine the effects
of gait analysis on surgical decision-making in children with cerebral palsy
(CP). 178 ambulatory children with CP (110 male; age 10.3+/-3.8 years) being
considered for lower extremity orthopaedic surgery underwent gait analysis and
were randomized into one of two groups: gait report group (N=90), where the
orthopaedic surgeon received the gait analysis report, and control group (N=88),
where the surgeon did not receive the gait report. Data regarding specific
surgeries were recorded by the treating surgeon before gait analysis, by the gait
laboratory surgeon after gait analysis, and after surgery. Agreement between the
treatment done and the gait analysis recommendations was compared between groups
using the 2-sided Fisher's Exact test. When a procedure was planned initially and
also recommended by gait analysis, it was performed more often in the gait report
group (91% vs. 70%, p<0.001). When the gait laboratory recommended against a
planned procedure, the plan was changed more frequently in the gait report group
(48% vs. 27%, p=0.009). When the gait laboratory recommended adding a procedure,
it was added more frequently in the gait report group (12% vs. 7%, p=0.037).
These results provide a stronger level of evidence demonstrating that gait
analysis changes treatment decision-making and also reinforces decision-making
when it agrees with the surgeon's original plan.
CI - Copyright (c) 2011 Elsevier B.V. All rights reserved.

Langue : ANGLAIS