POUL, Jan, Karel URBÁŠEK, Jaroslava BAJEROVÁ, J. JADRNÝ, A. FEDROVÁ and Ludmila KAISER ŠRÁMKOVÁ. Přínos instrumentální pohybové analýzy pro indikaci chirurgické léčby u dětské mozkové obrny (A Contribution of Instrumental Gait Analysis to the Establishment of Surgical Indications in Cerebral Palsy). Acta Chirurgiae Orthopaedicae et Traumatologiae Čechoslovaca. 2011, vol. 78, No 3, p. 253–257. ISSN 0001-5415.
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Basic information
Original name Přínos instrumentální pohybové analýzy pro indikaci chirurgické léčby u dětské mozkové obrny
Name (in English) A Contribution of Instrumental Gait Analysis to the Establishment of Surgical Indications in Cerebral Palsy
Authors POUL, Jan (203 Czech Republic, guarantor, belonging to the institution), Karel URBÁŠEK (203 Czech Republic, belonging to the institution), Jaroslava BAJEROVÁ (203 Czech Republic, belonging to the institution), J. JADRNÝ (203 Czech Republic), A. FEDROVÁ (203 Czech Republic) and Ludmila KAISER ŠRÁMKOVÁ (203 Czech Republic, belonging to the institution).
Edition Acta Chirurgiae Orthopaedicae et Traumatologiae Čechoslovaca, 2011, 0001-5415.
Other information
Original language Czech
Type of outcome Article in a journal
Field of Study 30200 3.2 Clinical medicine
Country of publisher Czech Republic
Confidentiality degree is not subject to a state or trade secret
Impact factor Impact factor: 1.628 in 2009
RIV identification code RIV/00216224:14110/11:00055451
Organization unit Faculty of Medicine
UT WoS 000292533100011
Keywords in English motion analysis; cerebral palsy; instrumental gait analysis
Tags International impact
Changed by Changed by: Mgr. Michal Petr, učo 65024. Changed: 9/2/2012 10:26.
Abstract
Cílem studie je porovnat v souboru 297 dětí postižených spastickou formou dětské mozkové obrny (66 hemiparéz a 231 diparéz) klinické indikace k operačnímu výkonu s indikacemi určenými na základě vyšetření v laboratoři chůze s instrumentální pohybovou analýzou a navíc se zvláštním zřetelem na diskrepance mezi oběma indikačními metodami. Zatímco dříve laboratoře chůze produkovaly více méně akademické výstupy bez větší snahy o praktickou aplikaci (2, 10, 17) nebo se bádání opírálo jen o vizuální hodnocení různými skorovacími systémy (3), v poslední době se objevila řada prací s výraznou snahou o klinické uplatnění (1, 13, 14, 16, 24, 25, 27, 29). Vybudování laboratoře chůze v naší nemocnici nám umožnilo pracovat s touto sofistikovanou diagnostickou metodou od června 2009.
Abstract (in English)
PURPOSE OF THE STUDY To evaluate our experience with indications for surgery based on instrumental gait analysis in cerebral palsy children, and to compare them with those drawn from the results of clinical examination. MATERIAL AND METHODS The gait analysis laboratory was built in the Paediatric Hospital of the Faculty of Medicine in Brno in the 2008/09 pe riod with support of the Norwegian funds. It is equipped with eight optical cameras, two auxiliary motion-picture video cameras, two force platforms and a telemetry system for electromyography. Between June 2009 and March 2010 a total of 297 children with spastic cerebral palsy, 66 with hemiparesis and 231 with diparesis were examined. RESULTS On the basis of instrumental gait analysis, indications for surgery were established in 19 hemiparetic and 88 diparetic patients, which meant a new indication in 107 children. In 14 children, the results of gait analysis led to abandoning former indications for surgery based on clinical examination only while, in 13 children, they backed up the surgical indications in spite of the negative results of clinical examination. In six children a so-called superclinical decision was made, i.e., the results of repeated clinical examinations over-weighed those of instrumental gait analysis either in favour of or against surgery. DISCUSSION Based on the gait analysis results, a change in treatment plans was made in 27 out of 297 children (9 %). This is in contrast with the findings of other authors who report a much higher rate of treatment planning changes (52-70 %) In our study the use of instrumental gait analysis allowed us to decrease the frequency of surgical indications by 4.7 %. Other authors have achieved a higher value, up to 13 %. Unlike other studies, ours did not confirm the effect of gait analysis outcomes on an increase in the number of one-stage multi-level surgical procedures. CONCLUSIONS Instrumental gait analysis is a great contribution to the diagnosis of movement disorders in children with cerebral palsy.
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