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Edinburgh, United Kingdom

Tang K.T.,University of Strathclyde | Tang K.T.,St Jamess Hospital | Richardson A.M.,Anderson Gait Analysis Laboratory | Maxwell D.,United Technologies | And 3 more authors.
Archives of Physical Medicine and Rehabilitation | Year: 2013

Objective To explore the use of an activity monitor (AM) to objectively characterize free-living physical activity (F-LPA) in children with mobility impairment resulting from cerebral palsy (CP). Design First, a validation study compared outcomes from the AM with video evidence. Second, multiday F-LPA was characterized. Relationships between laboratory measures and F-LPA were explored. Setting The evaluation study was conducted in a laboratory environment. F-LPA monitoring was conducted in the participants' free-living environment. Participants Convenience sample of ambulatory children (N=15; 11 boys, 4 girls) aged 5 to 17 years with CP undergoing gait analysis. Interventions Not applicable. Main Outcome Measures Accuracy of the AM for sitting/lying time, upright time, stepping time, and strides taken. Daily volumes of F-LPA of children with CP. Results AM outcomes in comparison with video-based analysis were (mean ± SD) 97.4%±2.7%, 101.1%±1.5%, 99.5%±6.6%, 105.6%±15.8%, and 103.8%±10.1% for sitting/lying time, upright time, standing time, stepping time, and stride count, respectively. Participants' daily F-LPA demonstrated considerable variation: mean standing time ± SD, 2.33±.96h/d; mean stepping time ± SD, 1.68±.86h/d; mean steps per day ± SD, 8477±4528; and mean sit-to-stand transitions per day ± SD, 76±49. Laboratory-measured cadence and mobility level were related to F-LPA, but not directly. Conclusions The AM demonstrated excellent ability to determine sitting/lying and upright times in children with CP. Stepping time and stride count had lower levels of agreement with video-based analysis but were comparable to findings in previous studies. Crouch gait and toe walking had an adverse effect on outcomes. The F-LPA data provided additional information on children's performance not related to laboratory measures, demonstrating the added value of using this objective measurement technique. © 2013 by the American Congress of Rehabilitation Medicine.

Jagadamma K.C.,Queen Margaret University | Coutts F.J.,Queen Margaret University | Mercer T.H.,Queen Margaret University | Herman J.,Anderson Gait Analysis Laboratory | And 3 more authors.
Disability and Rehabilitation: Assistive Technology | Year: 2015

Purpose: This exploratory trial investigated the effects of rigid ankle foot orthoses (AFO) with an optimally cast Angle of the Ankle in the AFO (AAAFO) on the gait of children with Cerebral Palsy (CP), and whether tuning of the AFO - Footwear Combination (AFO-FC) further affected gait. Methods: Eight children with CP underwent gait analysis and tuning of their AFO-FCs using a 3-D motion analysis system. Comparisons were carried out for selected gait parameters between three conditions - barefoot, non-tuned AFO-FC and tuned AFO-FC. Results: In comparison to barefoot gait, walking with a non-tuned AFO-FC produced significant (p < 0.05) improvements in several key gait parameters. Compared to the non-tuned AFO-FC, on average a tuned AFO-FC produced a significant reduction in peak knee extension and knee ROM during gait. However, when examined as case studies, it was observed that the type of gait pattern demonstrated while wearing a non-tuned AFO-FC affected the outcomes of tuning. Conclusions: The findings of the current study indicate the potential benefits of using rigid AFO-FC with optimal AAAFO and tuning of AFO-FCs. This study emphasises the need for categorising children with CP based on their gait patterns when investigating the effects of interventions such as AFOs. © 2014 Informa UK Ltd.

Hillman S.J.,Anderson Gait Analysis Laboratory | Donald S.C.,University of Edinburgh | Herman J.,Anderson Gait Analysis Laboratory | McCurrach E.,Anderson Gait Analysis Laboratory | And 3 more authors.
Gait and Posture | Year: 2010

The aim of this study was to assess the repeatability of an observational gait analysis score that was developed specifically for unilateral amputees. Ten videotaped sequences were analysed by six experienced observers on two separate occasions. Data were analysed using percentage agreement, the kappa statistic and the coefficient of repeatability. The score demonstrated good intraobserver repeatability with an average repeatability coefficient of 3 (range 1.5-4.6). Interobserver repeatability was poor with a repeatability coefficient of 5.9. This score could be used in practice to assess amputees and is most repeatable if used by the same observer to evaluate changes in patients over time. © 2010 Elsevier B.V.

Jagadamma K.C.,Queen Margaret University | Owen E.,Child Development Center | Coutts F.J.,Queen Margaret University | Herman J.,Anderson Gait Analysis Laboratory | And 3 more authors.
Prosthetics and Orthotics International | Year: 2010

The effects of tuning the AFO footwear combination (AFOFC) for an adult with post-stroke hemiplegia were investigated. Gait analysis and tuning were carried out using a Vicon 3D motion analysis system and two force plates. Tuning of the AFOFC was accomplished by gradually modifying its design over a number of gait trials, to achieve optimal (i.e., as close as possible to normal, within the capability of the patient) knee kinematics and alignment of the Ground Reaction Force vector (GRF) relative to the knee joint. Heel wedges and a stiff rocker were used to tune mid-stance and terminal stance, respectively. Temporal-spatial parameters and selected kinetic and kinematic variables were compared between the non-tuned AFOFC, the tuned AFOFC immediately after tuning, and the tuned AFOFC after three months. There were several changes after three months compared to the non-tuned AFOFC, including improvement in stride length and a reduction in knee hyperextension. A subjective reduction in knee pain and improvement in function were also reported. The feasibility and the lack of objective evidence of tuning AFOFCs as a part of a clinical service need to be addressed in future research. © 2010 ISPO.

Rose G.E.,Anderson Gait Analysis Laboratory | Lightbody K.A.,University of Edinburgh | Ferguson R.G.,University of Edinburgh | Walsh J.C.,Anderson Gait Analysis Laboratory | Robb J.E.,Anderson Gait Analysis Laboratory
Gait and Posture | Year: 2010

Eighteen children with diplegic cerebral palsy and no history of orthopaedic surgery had two gait analyses a mean of 6.3 years apart to analyse the effects of time on their gait. The mean age of the children at first analysis was 7.7 years (range 4.4-13.3 years). The data was analysed as a whole group (18 children) and as two sub-groups of nine children: those with a shorter follow-up (mean 5.0 years) and those with a longer follow-up (mean 7.5 years) between analyses. The following significant bilateral changes were seen in the whole group and longer follow-up sub-group: deterioration in the range of knee flexion, mid-stance knee flexion, peak knee extension in stance and hamstring length and an improvement in mean and maximum hip rotation. Temporal data showed no significant changes once normalised. There were no bilateral significant changes in data from children evaluated at a mean of 5 years follow-up. GMFCS scores generally improved over time despite the significant increase in flexed knee gait. There was no significant change in gait deviation index in any group over time. There was an increase in body mass index in 16 children but there was no correlation between this and the degree of mid-stance knee flexion. These findings may have implications for longer term follow-up of children with cerebral palsy into adulthood. © 2009 Elsevier B.V. All rights reserved.

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