Spine Biomechanics During Gait Following Lower Extremity Treatment in Different Patient Groups
- Conditions
- Cerebral PalsyLeg Length Inequality
- Interventions
- Other: Shoe insoleOther: Ankle foot orthosisOther: Modified shoe with sole lift
- Registration Number
- NCT01803243
- Lead Sponsor
- University Children's Hospital Basel
- Brief Summary
Measuring spine dynamics is a necessity in order to better understand gait deviations throughout the whole body and to evaluate treatment effects on spinal movement during gait. However, the full body marker sets that are typically used in opto-electronic 3D gait analyses either disregard the spine entirely or regard it as a rigid structure. Therefore, the purpose of this study is to use an enhanced trunk marker set in order to evaluate the biomechanical effects of lower extremity treatments on spine dynamics in patients with different pathologies.
It has been hypothesized that
1. the enhanced trunk marker set is a reliable method for the measurement of spine dynamics during gait in patients with deviations occurring secondary to leg length inequality.
2. the enhanced trunk marker set is a reliable method for the measurement of spine dynamics during gait in patients that present both primary and secondary deviations such as seen in hemiplegic and diplegic cerebral palsy.
3. treatment by means of either a shoe insole or a modified shoe with sole lift on the shorter side has an effect on spine dynamics during gait in patients with leg length inequality.
4. treatment by means of an ankle foot orthosis to control the foot position has an effect on spine dynamics during gait in patients with hemiplegic and diplegic cerebral palsy.
To verify the hypotheses, instrumented gait analyses with a standard full body marker set and the enhanced trunk marker set will be carried out before and immediately after an orthotic lower extremity treatment in the respective patient group.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 20
- Diagnosed structural leg length inequality (minimum 1% of body height)
- Several different aetiologies (except neurological)
- Able to walk a distance of minimum 50 meters without any assistive device
- Leg length inequality due to neurological aetiology
- Structural deformities of the spine
- Obesity (> 95th BMI-per-age percentile)
- Injuries of the locomotor system which led to persistent deformities
Hemiplegic cerebral palsy patients:
Inclusion Criteria:
- Diagnosed hemiplegic cerebral palsy (Gross Motor Function Classification System for Cerebral Palsy (GMFCS): Levels I and II)
- Able to walk a distance of minimum 50 meters barefoot and without any assistive device
Exclusion Criteria:
- Structural deformities of the spine
- Any previous surgical and casting treatments as well as botulinumtoxin treatments within preceding 6 months.
- Obesity (> 95th BMI-per-age percentile)
- Injuries of the locomotor system which led to persistent deformities
Diplegic cerebral palsy patients:
Inclusion Criteria:
- Diagnosed diplegic cerebral palsy (Gross Motor Function Classification System for Cerebral Palsy (GMFCS): Levels I and II)
- Able to walk a distance of minimum 50 meters barefoot and without any assistive device
Exclusion Criteria:
- Structural deformities of the spine
- Any previous surgical and casting treatments as well as botulinumtoxin treatments within preceding 6 months.
- Obesity (> 95th BMI-per-age percentile)
- Injuries of the locomotor system which led to persistent deformities
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Leg length correction Modified shoe with sole lift The shorter leg in a sample of 15 patients with structural leg length inequality will be corrected by either a shoe insole or a modified shoe with sole lift. Leg length correction Shoe insole The shorter leg in a sample of 15 patients with structural leg length inequality will be corrected by either a shoe insole or a modified shoe with sole lift. Control of foot position 1 Ankle foot orthosis The foot position in in a sample of 15 patients with hemiplegic cerebral palsy will be controlled by an ankle foot orthosis. Control of foot position 2 Ankle foot orthosis The foot position in in a sample of 15 patients with diplegic cerebral palsy will be controlled by an ankle foot orthosis.
- Primary Outcome Measures
Name Time Method Reliability of the enhanced trunk marker set for the measurement of spinal kinematics in patients with leg length inequality and cerebral palsy during gait. Data will be collected between April 2013 and June 2015. Each patient will be measured before and immediately after an orthotic treatment (both measurements within 1 hour). Parameters include lumbar, thoracic and cervical spine curvature angles in the sagittal and frontal planes and segmental rotation angles in the transverse plane.
Immediate changes in spinal kinematics in patients with leg length inequality and cerebral palsy during gait following an orthotic lower extremity treatment. Data will be collected between April 2013 and June 2015. Each patient will be measured before and immediately after the orthotic treatment (both measurements within 1 hour). Parameters include lumbar, thoracic and cervical spine curvature angles in the sagittal and frontal planes and segmental rotation angles in the transverse plane.
- Secondary Outcome Measures
Name Time Method Immediate changes in spatio-temporal gait parameters and kinematics and kinetics of peripheral joints in patients with leg length inequality and cerebral palsy during gait following an orthotic lower extremity treatment. Data will be collected between April 2013 and June 2015. Each patient will be measured before and immediately after the orthotic treatment (both measurements within 1 hour). Parameters include gait speed, cadence and single and double limb support as well as angles, torques and powers of peripheral joints in all three planes.
Trial Locations
- Locations (1)
University Children's Hospital Basel
🇨🇭Basel, Switzerland