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Saint Paul, MN, United States

Ganley K.J.,Northern Arizona University | Paterno M.V.,Sports Medicine Biodynamics Center | Miles C.,Cindy Miles and Associates | Stout J.,Center for Gait and Motion Analysis | And 3 more authors.
Pediatric Physical Therapy | Year: 2011

Purpose: The American Physical Therapy Association Section on Pediatrics developed a task force to summarize fitness guidelines for children and adolescents. The purposes of this article were to review components, measurement methods, and consequences of physical fitness, and to summarize evidence-based activity recommendations for youth. Summary of Key Points: Health-related fitness is comprised of body composition, flexibility, cardiorespiratory endurance, and muscular strength and endurance. Each of these components is reviewed in terms of definition, assessment, normative values, and recommendations. Conclusions: The task force supports the guidelines of the US Department of Health and Human Services, which state that to promote overall health and wellness, youth should participate in 60 minutes or more of physical activity every day. Recommendations for Clinical Practice: Physical therapists should apply research relevant to health-related fitness when treating youth. Promoting fitness, health, and wellness in our communities is a responsibility all therapists should assume. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins and Section on Pediatrics of the American Physical Therapy Association. Source

Agarwal-Harding K.J.,Stanford University | Schwartz M.H.,Center for Gait and Motion Analysis | Schwartz M.H.,University of Minnesota | Delp S.L.,Stanford University
Journal of Biomechanics | Year: 2010

Crouch gait, one of the most prevalent movement abnormalities among children with cerebral palsy, is frequently treated with surgical lengthening of the hamstrings. To assist in surgical planning many clinical centers use musculoskeletal modeling to help determine if a patient's hamstrings are shorter or lengthen more slowly than during unimpaired gait. However, some subjects with crouch gait walk slowly, and gait speed may affect peak hamstring lengths and lengthening velocities. The purpose of this study was to evaluate the effects of walking speed on hamstrings lengths and velocities in a group of unimpaired subjects over a large range of speeds and to determine if evaluating subjects with crouch gait using speed matched controls alters subjects' characterization as having "short" or "slow" hamstrings. We examined 39 unimpaired subjects who walked at five different speeds. These subjects served as speed-matched controls for comparison to 74 subjects with cerebral palsy who walked in crouch gait. Our analysis revealed that peak hamstrings length and peak lengthening velocity in unimpaired subjects increased significantly with increasing walking speed. Fewer subjects with cerebral palsy were categorized as having hamstrings that were "short" (31/74) or "slow" (38/74) using a speed-matched control protocol compared to a non-speed-matched protocol (35/74 "short", 47/74 "slow"). Evaluation of patients with cerebral palsy using speed-matched controls alters and may improve selection of patients for hamstrings lengthening procedures. © 2010 Elsevier Ltd. Source

Hicks J.L.,Stanford University | Delp S.L.,Stanford University | Schwartz M.H.,Center for Gait and Motion Analysis | Schwartz M.H.,University of Minnesota
Gait and Posture | Year: 2011

Many patients respond positively to treatments for crouch gait, yet surgical outcomes are inconsistent and unpredictable. In this study, we developed a multivariable regression model to determine if biomechanical variables and other subject characteristics measured during a physical exam and gait analysis can predict which subjects with crouch gait will demonstrate improved knee kinematics on a follow-up gait analysis. We formulated the model and tested its performance by retrospectively analyzing 353 limbs of subjects who walked with crouch gait. The regression model was able to predict which subjects would demonstrate 'Improved' and 'Unimproved' knee kinematics with over 70% accuracy, and was able to explain approximately 49% of the variance in subjects' change in knee flexion between gait analyses. We found that improvement in stance phase knee flexion was positively associated with three variables that were drawn from knowledge about the biomechanical contributors to crouch gait: (i) adequate hamstrings lengths and velocities, possibly achieved via hamstrings lengthening surgery, (ii) normal tibial torsion, possibly achieved via tibial derotation osteotomy, and (iii) sufficient muscle strength. © 2011 Elsevier B.V. Source

Gutknecht S.M.,Gillette Childrens Specialty Healthcare | Schwartz M.H.,University of Minnesota | Schwartz M.H.,Center for Gait and Motion Analysis | Munger M.E.,Center for Gait and Motion Analysis
Developmental Medicine and Child Neurology | Year: 2015

Aim: The aim of this study was to retrospectively analyze changes in age- and sex-adjusted body mass index (BMI) in ambulatory children with cerebral palsy (CP) who underwent selective dorsal rhizotomy (SDR). Method: Raw BMI, age- and sex-adjusted BMI z-scores, weight classification status, energy expenditure, and ambulation function were calculated before and after SDR at multiple post-SDR time points: 6 to <24 months, 24 to <48 months, 48 to <72, and 72 to <96 months. Linear mixed models were used to analyze changes in raw BMI, BMI z-scores, energy expenditure, and ambulation function. Results: Pre- and post-surgical data were available for 363 children diagnosed with CP who underwent SDR (219 males, 144 females; mean age 6y [SD 2y 1mo]; mean BMI z-score 0.09 [SD 1.21]). Data from additional post-surgical time points were collected on subsamples. Although raw BMI significantly increased (p<0.01), these increases were consistent with anticipated growth. BMI z-scores did not significantly change over the 10-year study period. Interpretation: Concerns of unhealthy weight gain following SDR are not supported by this study. Further work examining possible risk factors for BMI increase following SDR, as well as examining disparities in existing criteria for patient selection, is merited. © 2015 Mac Keith Press. Source

Beattie C.,200 University Ave E | Gormley M.,200 University Ave E | Wervey R.,Center for Gait and Motion Analysis | Wendorf H.,200 University Ave E
Journal of Pediatric Rehabilitation Medicine | Year: 2016

PURPOSE: The purpose of this proof of concept study is to demonstrate that electromyographic (EMG) activation patterns of leg muscles differ predictably among patients with predominantly spasticity, patients with predominantly dystonia, and typically developing control subjects during rest, volitional movement, and passively induced movement. METHODS: Eight control subjects, 6 subjects with dystonia, and 7 subjects with spasticity were recruited, ages 6-25 years. Surface EMG sensors were applied over 4 muscle groups of each leg. EMG recordings and video were obtained during rest, quick stretch, and volitional movement. The number of muscles active during 3 resting, 4 quick stretch, and 8 volitional movement items were averaged and compared across subject groups. RESULTS: Control subjects showed minimal numbers of muscles active during resting, quick stretch, or volitional movement activities. Spastic subjects showed multiple muscles responding with high amplitude to quick stretch but not to volitional movement activities. Dystonic subjects showed multiple muscles responding to volitional movement activities but not to quick stretch. Analysis with a Kruskal-Wallis test indicated significant differences between the three groups in numbers of muscles activated during quick stretch activities (p = 0.017) and volitional movement activities (p = 0.005). CONCLUSION: EMG data collected with this protocol may be useful for distinguishing spastic from dystonic hypertonia. © 2016 - IOS Press and the authors. All rights reserved. Source

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