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Upper extremity dynamics during Lofstrand crutch-assisted gait in children with myelomeningocele. Gait Posture 2009 Nov;30(4):511-7 PMID: 19726191

Pubmed ID

19726191

Abstract

The use of quantitative models for evaluating upper extremity (UE) dynamics in children with myelomeningocele (MM) is limited. A biomechanical model for assessment of UE dynamics during Lofstrand crutch-assisted gait in children with MM is presented. This pediatric model may be a valuable tool for clinicians to characterize crutch-assisted gait, which may advance treatment monitoring, crutch prescription, and rehabilitation planning for children with MM. Nine subjects with L3 or L4 level myelodysplasia (mean+/-S.D. age: 11.1+/-3.8 years) were analyzed during forearm crutch-assisted gait: (1) reciprocal gait and (2) swing-through gait. Three-dimensional (3D) dynamics of the UE were acquired and the Pediatric Outcomes Data Collection Instrument (PODCI) was administered. The goal of this study was to determine if meaningful differences occur between gait patterns in UE kinematics and kinetics, and if correlations exist between dynamics and functional outcomes. Temporal-distance parameters showed significant differences between reciprocal and swing-through gait in stride length, and stance duration. All joint ranges of motion were greater during swing-through gait. Thorax, elbow and crutch ranges of motion were found to be significantly different between gait patterns. Kinetic results demonstrated significant differences between reciprocal and swing-through gait, bilaterally, at all joints for the force variables of mean superior/inferior force, range of force, and maximum inferior force. Functional outcomes were strongly correlated with joint dynamics. Accurate quantitative assessment is essential for preventing injury in long-term crutch users. This study has potential for improving clinical intervention strategies and therapeutic planning of ambulation for children with MM.

Author List

Slavens BA, Sturm PF, Bajournaite R, Harris GF

Authors

Gerald Harris PhD Director in the Orthopaedic Research Engineering Center (OREC) department at Marquette University
Brooke Slavens BS,MS,PhD Assistant Professor in the Occupational Science & Technology department at University of Wisconsin - Milwaukee




Scopus

2-s2.0-70349232196   19 Citations

MESH terms used to index this publication - Major topics in bold

Biomechanical Phenomena
Crutches
Female
Gait Disorders, Neurologic
Humans
Kinetics
Male
Meningomyelocele
Muscle Contraction
Muscle, Skeletal
Transducers
Upper Extremity
jenkins-FCD Prod-300 626508253d14e4184314fb9f66322a03a5906796