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Lobo da Costa P.H.,Federal University of Sao Carlos | Azevedo Nora F.G.S.,Federal University of Sao Carlos | Vieira M.F.,Federal University of Goais | Bosch K.,Gait Laboratory | Rosenbaum D.,University of Munster
Gait and Posture | Year: 2013

The purpose of this study was to describe the effects of lower limb positioning and shoe conditions on stability levels of selected single leg ballet poses performed in demi-pointe position. Fourteen female non-professional ballet dancers (mean age of 18.4±2.8 years and mean body mass index of 21.5±2.8kg/m2) who had practiced ballet for at least seven years, without any musculoskeletal impairment volunteered to participate in this study. A capacitive pressure platform allowed for the assessment of center of pressure variables related to the execution of three single leg ballet poses in demi pointé position: attitude devant, attitude derriére, and attitude a la second. Peak pressures, contact areas, COP oscillation areas, anterior-posterior and medio-lateral COP oscillations and velocities were compared between two shoe conditions (barefoot versus slippers) and among the different poses. Barefoot performances produced more stable poses with significantly higher plantar contact areas, smaller COP oscillation areas and smaller anterior-posterior COP oscillations. COP oscillation areas, anterior-posterior COP oscillations and medio-lateral COP velocities indicated that attitude a la second is the least challenging and attitude derriére the most challenging pose. © 2012 Elsevier B.V.

Johnsen E.L.,Aarhus University Hospital | Sunde N.,Aarhus University Hospital | Mogensen P.H.,Gait Laboratory | Ostergaard K.,Aarhus University Hospital
European Journal of Neurology | Year: 2010

Background: Deep brain stimulation (DBS) of the subthalamic nucleus (STN) is effective in alleviating Parkinson's disease (PD) symptoms (tremor, rigidity and bradykinesia) and may improve gait and postural impairment associated with the disease. However, improvement of gait is not always as predictable as the clinical outcome. This may relate to the type of gait impairment or localization of the active DBS contact. Methods: The active contact was visualized on peri-operative magnetic resonance imaging in 22 patients with idiopathic PD, consecutively treated with bilateral STN DBS. Stimulation site was grouped as either in the dorsal/ventral STN or medial/lateral hereof and anterior/posterior STN or medial/lateral hereof. The localization was compared with relative improvement of clinical outcome (UPDRS-III). In 10 patients, quantitative gait analyses were performed, and the improvement in gait performance was compared with stimulation site in the STN. Results: Of 44 active contacts, 77% were inside the nucleus, 23% were medial hereof. Stimulation of the dorsal half improved UPDRS-III significantly more than ventral STN DBS (P = 0.02). However, there were no differences between anterior and posterior stimulation in the dorsal STN. Step velocity and length improved significantly more with dorsal stimulation compared with ventral stimulation (P = 0.03 and P = 0.02). Balance during gait was also more improved with dorsal stimulation compared with ventral stimulation. Conclusions: Deep brain stimulation of the dorsal STN is superior to stimulation of the ventral STN. Possible different effects of stimulation inside the nucleus underline the need for exact knowledge of the active stimulation site position to target the most effective area. © 2009 EFNS.

Elhassan Y.,Gait Laboratory
BMJ case reports | Year: 2013

We report a greenstick fracture of the patella in an ambulant boy with diplegic cerebral palsy (CP). The boy was known to have knee crouch which was documented in our gait laboratory. Greenstick fractures usually occur in the long bones of children and are caused by a bending force. This is the first report of a patellar greenstick fracture and provides a unique insight into the propagation of patellar fractures in CP crouch.

Ryan J.,Trinity College Dublin | Walsh M.,Gait Laboratory | Gormley J.,Trinity College Dublin
Adapted Physical Activity Quarterly | Year: 2014

This study investigated the ability of published cut points for the RT3 accelerometer to differentiate between levels of physical activity intensity in children with cerebral palsy (CP). Oxygen consumption (metabolic equivalents; METs) and RT3 data (counts/min) were measured during rest and 5 walking trials. METs and corresponding counts/min were classified as sedentary, light physical activity (LPA), and moderate to vigorous physical activity (MVPA) according to MET thresholds. Counts were also classified according to published cut points. A published cut point exhibited an excellent ability to classify sedentary activity (sensitivity = 89.5%, specificity = 100.0%). Classification accuracy decreased when published cut points were used to classify LPA (sensitivity = 88.9%, specificity = 79.6%) and MVPA (sensitivity = 70%, specificity = 95–97%). Derivation of a new cut point improved classification of both LPA and MVPA. Applying published cut points to RT3 accelerometer data collected in children with CP may result in misclassification of LPA and MVPA. © 2014 Human Kinetics, Inc.

Rosenbaum D.,University of Munster | Westhues M.,University of Munster | Bosch K.,Gait Laboratory
Gait and Posture | Year: 2013

Gait speed has been shown to influence foot loading patterns in adults but the mechanism has not been investigated in children. The present study investigated the effects of changes in gait speed on foot loading characteristics in 20 typically developing children who participated in plantar pressure measurements at normal, slow and fast walking speeds. In spite of shorter contact times in the fast walking speed condition, significantly increased foot loading was seen in the hindfoot, medial and central forefoot and toes while it slightly decreased in the lateral midfoot and forefoot. The results generally confirm the findings in adults that gait speed does not uniformly affect foot loading characteristics and that these effects should be kept in mind when comparing different subject groups or children at repeated measurement occasions. © 2013 Elsevier B.V.

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