Shriners Hospitals for ChildrenR

Greenville, United States

Shriners Hospitals for ChildrenR

Greenville, United States

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MacWilliams B.A.,Shriners Hospitals for Children | MacWilliams B.A.,University of Utah | McMulkin M.L.,Shriners Hospitals for Children | Davis R.B.,Shriners Hospitals for ChildrenR | And 3 more authors.
Gait and Posture | Year: 2016

Torsional deformities of the femur in children may occur as a result of either idiopathic or neuromuscular disorders and may be corrected with derotational osteotomies. Regardless of the underlying etiology, neither the effects of the torsional pathologies nor the alterations resulting from corrective osteotomies are well understood. A study of children with isolated femoral anteversion undergoing a single corrective procedure may assist in understanding the biomechanics of the pathology and the efficacy of surgical correction. A multicenter retrospective study included 25 subjects with idiopathic femoral anteversion who underwent femoral derotational osteotomy and had completed pre and postoperative gait analyses. Both changes with surgery and comparisons to typically developing controls were analyzed. Reduced gait pathology and expected improvements in hip rotation and foot progression were found with derotational osteotomy. Overall gait pathology and pathological differences in pelvic tilt, hip flexion moment and knee adduction moment were found comparing anteversion subjects with typically developing subjects. Following surgery, only hip rotation was significantly and clinically different from typically developing subjects, changing from relatively inward to outward. Idiopathic femoral anteversion creates multifaceted and significant alterations to normal gait and should not be considered solely a cosmetic issue. Additionally, the efficacy of derotational osteotomy is illustrated and may be more broadly applied to other conditions where pathologic femoral anteversion is present. © 2016 Elsevier B.V.


Schmitz A.,University of Wisconsin - Madison | Buczek F.L.,Shriners Hospitals for ChildrenR | Buczek F.L.,Lake Erie College | Bruening D.,Shriners Hospitals for ChildrenR | And 3 more authors.
Computer Methods in Biomechanics and Biomedical Engineering | Year: 2016

The objective of this study was to determine how marker spacing, noise, and joint translations affect joint angle calculations using both a hierarchical and a six degrees-of-freedom (6DoF) marker set. A simple two-segment model demonstrates that a hierarchical marker set produces biased joint rotation estimates when sagittal joint translations occur whereas a 6DoF marker set mitigates these bias errors with precision improving with increased marker spacing. These effects were evident in gait simulations where the 6DoF marker set was shown to be more accurate at tracking axial rotation angles at the hip, knee, and ankle. © 2015 Taylor & Francis.


Schmitz A.,University of Wisconsin - Madison | Buczek F.L.,Lake Erie College | Bruening D.,Shriners Hospitals for ChildrenR | Rainbow M.J.,Harvard University | And 2 more authors.
Computer Methods in Biomechanics and Biomedical Engineering | Year: 2015

The objective of this study was to determine how marker spacing, noise, and joint translations affect joint angle calculations using both a hierarchical and a six degrees-of-freedom (6DoF) marker set. A simple two-segment model demonstrates that a hierarchical marker set produces biased joint rotation estimates when sagittal joint translations occur whereas a 6DoF marker set mitigates these bias errors with precision improving with increased marker spacing. These effects were evident in gait simulations where the 6DoF marker set was shown to be more accurate at tracking axial rotation angles at the hip, knee, and ankle. © 2015 Taylor & Francis


PubMed | Shriners Hospitals for ChildrenR
Type: Journal Article | Journal: Journal of pediatric rehabilitation medicine | Year: 2012

A multi-site Randomized-Controlled Trial compared a home-based Supported Speed Treadmill Training Exercise Program (SSTTEP) with a strengthening exercise program in children with cerebral palsy (CP) on the following categories; Participation, quality of life (QOL), self-concept, goal attainment, and satisfaction.Twenty-six children with spastic cerebral palsy were assigned by site-based block randomization to the SSTTEP (n=14) or strengthening exercise (n=12) group. Both groups participated in a two week clinic-based induction period and continued the intervention at home for ten weeks. Data were collected at baseline, post-intervention (12 weeks), and follow-up (16 weeks). Assessments included the Canadian Occupational Performance Measure, Childrens Assessment of Participation and Enjoyment Scale, Pediatric Quality of Life Cerebral Palsy Module, and Piers-Harris Childrens Self-Concept Scale. Evaluators were blinded to group assignment at two sites.Satisfaction and performance on individual goals, participation, and parent-reported QOL improved in both groups with improvement maintained for four weeks post intervention.The hypothesis that the SSTTEP group would have better outcomes than the exercise group was not supported. However, both groups showed that children with CP can make gains in participation, individual goals, and satisfaction following a 12-week intensive exercise intervention, and these findings persisted for four weeks post intervention.


PubMed | Shriners Hospitals for ChildrenR
Type: Comparative Study | Journal: Gait & posture | Year: 2011

The purpose of this study was to determine if mobility goals were met when set and rated by the family using a modified Goal Attainment Scale following lower extremity orthopedic surgery or on follow-up without surgery.Parents were asked to establish the top three goals for their childs mobility during a visit to the Motion Analysis Laboratory. Three groups of subjects were established: (1) 25 children with CP who had surgery, (2) 13 children with CP who did not have surgery and (3) 13 children without CP who had surgery. Goals were rated at the follow-up visit to the Motion Analysis Laboratory a mean of 12.4 months after initial visit using a non-criterion reference scale. The PODCI, Gait Deviation Index and Gillette FAQ were additional standardized tools used to measure outcomes. Data were reviewed retrospectively.Both groups that had surgery on average met their goals. The group that did not have surgery did not, on average, meet their goals (overall, no change). Significant improvements were noted in both surgery groups on the PODCI and Gait Deviation Index while no changes were found for the group without surgery.Generally, goals are met following orthopedic surgery when set and rated by the family using a modified Goal Attainment Scale in the Motion Analysis Laboratory. However, goals are not universally met which presents an opportunity to improve the goal setting and evaluation process. Goals identified in this study are specific and unique to the family and agree with other standardized outcome tools.

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