Resumen de Algunos Artículos Relevantes Sobre la Importancia del Análisis
de La Marcha
(Tomado de Medline)
The effect of preoperative gait analysis on orthopaedic decision making.
Title
The effect of preoperative gait analysis on orthopaedic decision making.
Author
Kay RM; Dennis S; Rethlefsen S; Reynolds RA; Skaggs DL; Tolo VT
Address
Childrens Hospital Los Angeles, CA 90027, USA.
Source
Clin Orthop, 2000 Mar, :372, 217-22
Abstract
The impact of preoperative gait analysis on the orthopaedic care of 97
patients (101 gait analyses) at the authors' institution was evaluated. For
the 70 patients for whom a specific treatment plan had been outlined before
the preoperative gait study, the treatment plan was altered in 62 (89%)
after the gait analysis study. In 10 of the 70 patients with specific
treatment plans before the gait study, the referring physician also served
as the physician in the gait laboratory; ultimate treatment was changed in
nine of these 10 patients. Of the 273 surgical procedures recommended
before the gait study in the 70 patients, 106 (39%) of these procedures
were not done when the gait laboratory data were considered. An average of
1.5 procedures per patient that were planned before the gait study
ultimately were not deemed necessary by the treating physician after the
addition of the gait data. An additional 110 procedures (1.6 per patient)
that had not been recommended before the gait study ultimately were
performed after addition of the gait laboratory data. This study shows that
ultimate surgical intervention frequently is altered by the addition of
gait laboratory.
Title
Gait analysis in cerebral palsy.
Author
Lee EH; Nather A; Goh J; Teng B; Bose K
Address
Source
Ann Acad Med Singapore, 1985 Jan, 14:1, 37-43
Abstract
Ambulation problems in cerebral palsy have been very difficult to analyse
because it is the central control system rather than the motor system that
is at fault. Until recently, decisions regarding surgical management has
been made on clinical grounds, which by and large, have been subjective.
Attempts to remedy this situation has resulted in the setting up of Gait
Analysis Laboratories to provide a more objective method of evaluation of
disorders of human motion. We have recently been using an opto-electronic
computer-based gait analysis system to analyse normal as well as abnormal
gait. Gait analysis can provide information regarding movements of both
lower limbs in three planes, ground reaction forces, joint torque and
dynamic electromyography. Children with various types of Cerebral Palsy
have been assessed. The results of four clinical gait assessment cases are
presented and discussed. Information provided by the Gait Analysis
Laboratory has introduced more objectivity in pre-operative planning for
these children.
Title
Value of gait analysis in the assessment of surgery in cerebral palsy.
Author
Lee EH; Goh JC; Bose K
Address
Department of Orthopaedic Surgery, National University of Singapore.
Source
Arch Phys Med Rehabil, 1992 Jul, 73:7, 642-6
Abstract
Twenty-three ambulatory children with cerebral palsy were assessed
preoperatively by a detailed clinical examination and by gait analysis
using a video-based gait analysis system (VICON). Surgery was then
performed based on either the clinical assessment alone or a combination of
clinical evaluation and gait analysis. About one year after surgery, a
postoperative clinical and gait analysis assessment was performed. Sixteen
children had improved and seven children had not improved after surgery.
Most of the children who had not improved were found to have had operations
that differed from those recommended by gait analysis. Dynamic EMG studies
were found to be useful in preoperative planning but did not show any
consistent improvement even in the children with good results. The
combination of a careful clinical assessment and gait analysis can produce
better results in surgery for children with cerebral palsy.
Title
Strategies for the assessment of pediatric gait in the clinical setting.
Author
Rose SA; Ounpuu S; DeLuca PA
Address
Rehabilitation Services, Newington Children's Hospital, CT 06111.
Source
Phys Ther, 1991 Dec, 71:12, 961-80
Abstract
Clinical gait analysis is a term that can be applied to numerous methods of
evaluating a subject's walking pattern. These methods may include
observation, videotaping, electromyography, kinematics, kinetics, and
energetics. Modern gait analysis is based on the integration of these
component methods of measurement to derive a complete analysis of gait. The
data may then be used to help determine the treatment course of a patient
with ambulatory problems or to document the effects of treatment. The
purpose of this article is to provide an overview of the individual
components of gait analysis. Emphasis will be placed on the type of
information that can be derived from each component and how the information
may be used clinically. Normal pediatric kinematics and kinetics are
provided with literature references for phasic electromyography and
temporal and stride variables. Two case examples illustrate the clinical
utility of gait analysis information applied to cerebral palsy in surgical
decision making and orthotic assessment. Guidelines are also provided for
the referral of patients to a gait analysis laboratory.
Title
Comparison of a clinical gait analysis method using videography and
temporal-distance measures with 16-mm cinematography.
Author
Stuberg WA; Colerick VL; Blanke DJ; Bruce W
Address
C. Louis Meyer Children's Rehabilitation Institute, University of Nebraska,
Omaha 68131.
Source
Phys Ther, 1988 Aug, 68:8, 1221-5
Abstract
The purpose of this study was to compare a clinical gait analysis method
using videography and temporal-distance measures with 16-mm cinematography
in a gait analysis laboratory. Ten children with a diagnosis of cerebral
palsy (means age = 8.8 +/- 2.7 years) and 9 healthy children (means age =
8.9 +/- 2.4 years) participated in the study. Stride length, walking
velocity, and goniometric measurements of the hip, knee, and ankle were
recorded using the two gait analysis methods. A multivariate analysis of
variance was used to determine significant differences between the data
collected using the two methods. Pearson product-moment correlation
coefficients were determined to examine the relationship between the
measurements recorded by the two methods. The consistency of performance of
the subjects during walking was examined by intraclass correlation
coefficients. No significant differences were found between the methods for
the variables studied. Pearson product-moment correlation coefficients
ranged from .79 to .95, and intraclass coefficients ranged from .89 to .97.
The clinical gait analysis method was found to be a valid tool in
comparison with 16-mm cinematography for the variables that were studied.
Title
Comparison of a clinical gait analysis method using videography and
temporal-distance measures with 16-mm cinematography.
Author
Stuberg WA; Colerick VL; Blanke DJ; Bruce W
Address
C. Louis Meyer Children's Rehabilitation Institute, University of Nebraska,
Omaha 68131.
Source
Phys Ther, 1988 Aug, 68:8, 1221-5
Abstract
The purpose of this study was to compare a clinical gait analysis method
using videography and temporal-distance measures with 16-mm cinematography
in a gait analysis laboratory. Ten children with a diagnosis of cerebral
palsy (means age = 8.8 +/- 2.7 years) and 9 healthy children (means age =
8.9 +/- 2.4 years) participated in the study. Stride length, walking
velocity, and goniometric measurements of the hip, knee, and ankle were
recorded using the two gait analysis methods. A multivariate analysis of
variance was used to determine significant differences between the data
collected using the two methods. Pearson product-moment correlation
coefficients were determined to examine the relationship between the
measurements recorded by the two methods. The consistency of performance of
the subjects during walking was examined by intraclass correlation
coefficients. No significant differences were found between the methods for
the variables studied. Pearson product-moment correlation coefficients
ranged from .79 to .95, and intraclass coefficients ranged from .89 to .97.
The clinical gait analysis method was found to be a valid tool in
comparison with 16-mm cinematography for the variables that were studied.
Title
Gait pattern in patients with spastic diplegic cerebral palsy who underwent
staged operations.
Author
Fabry G; Liu XC; Molenaers G
Address
Department of Orthopaedic Surgery, University Hospital Pellenberg,
Katholieke Universiteit Leuven, Belgium.
Source
J Pediatr Orthop B, 1999 Jan, 8:1, 33-8
Abstract
Fifteen patients with spastic diplegic cerebral palsy (CP) were monitored
for a mean length of 9.5 years after they underwent staged operations and
were evaluated by gait analysis, including joint motion in the sagittal
plane and the ground reaction force (GRF) in three dimensions. Results
showed an increased hip flexion (132%) at midstance, a reduction of peak
knee flexion (PKF) during swing (45%) accompanied by an augmented time of
PKF during swing (50%), and an increased dorsiflexion of the ankle during
swing (293%) as well as its time during the gait cycle, in comparison with
normal values. Moreover, significant decreases of the vertical GRF at the
terminal stance and the forward and backward GRF were present.
Additionally, it was found that a bilateral popliteal angle < 20 degrees is
acceptable in spastic CP. Staged operations gave unpredictable results in
the correction of contracture of the hamstrings, the Achilles tendon, and
the iliopsoas. The authors are convinced that gait analysis is useful in
evaluating these patients and enhances the results of operative treatment,
and they have since changed their approach toward multilevel simultaneous
corrections.
