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Biomedical subjects

L M Knutson

Publications and source records attributed to L M Knutson.

4 recordsLinked to original sources

Kinematic and electromyographic characteristics of children with cerebral palsy who exhibit genu recurvatum.

The objective of this article was to determine, using selected computerized gait analysis procedures, whether variation exists in the gait patterns of children with cerebral palsy who exhibit genu recurvatum. This descriptive study compared differences in kinematic, temporal-distance, and electromyographic (EMG) variables between two groups of children with cerebral palsy who exhibited genu recurvatum and age-matched controls. The setting was a motion analysis laboratory. Six children with cerebral palsy who showed genu recurvatum and a control group of four normal children participated in this study. Main outcome measures were hip-knee angle-angle diagrams, knee phase plane plots, knee angle versus time diagrams, stride length, cadence, single-limb support, and EMG data. Through use of hip-knee angle-angle diagrams, knee phase plane plots, and knee angle versus time diagrams, distinctive kinematic patterns emerged, allowing for grouping of subjects. Kinematic measures of knee angle at foot-floor contact and knee angle at greatest extension provided further support for the groups created, as did temporal-distance measures of stride length, cadence, and single-limb support. Analysis of variance procedures for the EMG data showed selected time points in the gait cycle during which differences between the groups were observed. Because differences in kinematic, temporal-distance, and EMG variables existed in this study to warrant grouping into two categories, physical therapists and orthopedic surgeons may need to vary the treatments they introduce dependent on the nature of the child's gait pattern.

Case-Control Studies

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Organizational Policy

Orthotic devices for ambulation in children with cerebral palsy and myelomeningocele.

Children with cerebral palsy and children with myelomeningocele frequently require orthotic devices for standing and walking. The purpose of this article is to review the literature on orthotic devices for walking, present principles of lower-extremity orthoses, discuss designs of orthoses, and consider criteria for selecting orthotic devices. Although discussion of the devices is specific to children with myelomeningocele and to children with cerebral palsy, the orthoses can be used with children having other disabilities. The information presented should be of value to clinicians, educators, and researchers interested in reviewing orthotic applications for children with disabilities.

Cerebral Palsy

Chiari pelvic osteotomy in cerebral palsy.

Hip subluxation and dislocation in patients with cerebral palsy are challenging problems. The Chiari pelvic osteotomy has been commonly recommended as a technique for hip stabilization when acetabular dysplasia is present. We evaluated the results of Chiari osteotomy without concomitant femoral osteotomy in 24 hips in 23 patients with an average follow-up of > 7 years. Evaluation consisted of a pain and function questionnaire, chart review, physical examination, and review of serial radiographs. At final follow-up, 19 of 24 (79%) of the hips were painless, and 21 of 24 hips (88%) permitted unlimited sitting. Seven of 24 (29%) of hips, however, had a migration index of > or = 30%. Painful hips were associated with a greater migration index preoperatively, at 1 year postoperatively, and at final follow-up, and a greater height of the osteotomy above the edge of the acetabulum. Deterioration in the migration index (resubluxation) occurred largely in the first year postoperatively. Alternative acetabular procedures, simultaneous femoral osteotomies, or both may improve on these results. Long-term follow-up studies are necessary to compare the results of different treatments for spastic hip subluxation and dislocation to determine optimal treatment.

Adolescent