Biomedical subjects

Bjørn Lofterød

Publications and source records attributed to Bjørn Lofterød.

3 recordsLinked to original sources

PubMed2006

[Cerebral palsy in children--motor function and new treatment strategies].

Substantial changes have taken place in the management of motor function in children with cerebral palsy during the last decade. The objective of this article is to describe some of these changes. The article is based on search of databases and own clinical experiences. New treatment methods have been introduced and the management is more specialised and individualised. No single treatment method has proven to be sufficient alone and the challenge is to find the best combination of methods. This requires the ability to cooperate across disciplines. Medical treatment of spasticity (botulinum toxin A, intrathecal baclofen) may be an alternative or a supplement to orthopaedic surgery. For children who can walk, preoperative gait analysis has made it easier to find the right time for an operation and to choice the right type of intervention. Physiotherapy has become task oriented and specifically goal directed, based on documented principles of motor learning, strength and fitness training. Correct choose and use of orthosis is an essential part of the treatment. The different types of cerebral palsy have different natural progressions, risk factors and needs of follow-up. A multidisciplinary clinical evaluation is therefore needed as a basis for choosing the right management strategy. Given the complexity of this disorder, priority between various focus areas for different age groups is a challenge. A close collaboration with the parents is therefore essential. Children with cerebral palsy are a relatively small group, and the increased specialisation may indicate that parts of the treatment should be centralised.

Cerebral Palsy↗

PubMed2005

[Gait analysis--a new diagnostic tool].

Three-dimensional gait analysis is a systematic measurement, description, and assessment of human gait. Gait analysis is established as a useful diagnostic tool in patients with gait problems, as it is not possible to obtain an adequate and detailed understanding of such a complex mechanism as gait in a conventional clinical examination. The method has provided a better understanding of both normal gait and abnormal gait patterns; it is a suitable instrument for evaluation of treatment results as well as for scientific work. The first gait laboratory for clinical use in Norway was established in 2002 in the Section for child neurology at Rikshospitalet University Hospital in Oslo, Norway. In this article the procedure for gait analysis is described and the clinical value is indicated by a case record of a child with cerebral palsy. Gait analysis has entailed a change of policy with regard to surgical treatment in this patient group. Previously, operative intervention at a single level was usual, whereas current practice involves simultaneous interventions at several levels of both lower extremities. After three years' experience we recommend gait analysis in routine diagnostics, particularly as a preoperative evaluation, in all children with gait problems and in the follow up after surgery or other treatment.

Adolescent↗

PubMed2004

[Orthopaedic problems in adults with cerebral palsy].

BACKGROUND: There is little information about the need for orthopaedic surgery in adults with cerebral palsy; we wanted to assess this problem. MATERIAL AND METHODS: The material included 37 adults with cerebral palsy (19 women and 18 men), mean age 39. The degree of physical disability was mild in 19 cases, moderate or severe in 18. The patients were assessed by clinical examination and radiographs of hips and spine. RESULTS: 15 patients had pain located to the spine or lower extremities but no-one had severe or invalidating pain. Subjects with moderate or severe disability had a markedly reduced range of motion in the hip and knee joints. Subluxation or dislocation of the hip joints was found in six patients but only one of them had hip pain. Orthopaedic surgery had been performed in 23 patients. In 8 patients we found indications for additional orthopaedic surgery aimed at relieving pain, reducing contractures or improving function. The most frequent procedures would be tenotomies in the hip and knee regions, heel cord lengthening, and triple arthrodesis of the foot. INTERPRETATION: Regular follow-up of adults with cerebral palsy is recommended in order to reveal musculoskeletal problems that can be improved by orthopaedic surgery.

Adult↗