Biomedical subjects

Leonhard Döderlein

Publications and source records attributed to Leonhard Döderlein.

6 recordsLinked to original sources

PubMed2006

Effects of a postoperative strength-training program on the walking ability of children with cerebral palsy: a randomized controlled trial.

OBJECTIVE: To investigate the effect of a postoperative strength-training program on the walking of children with cerebral palsy (CP). DESIGN: Randomized controlled trial. SETTING: Hospital rehabilitation department. PARTICIPANTS: Thirty-nine children with CP (age range, 6-16 y). After orthopedic surgery, the control group (n=20) followed a conventional physiotherapy (PT) program, and the strength-training group (n=19) followed a strength-training program in addition to the conventional PT. Twenty-nine age-matched healthy children were used as references. INTERVENTION: A 9-month strength-training program. MAIN OUTCOME MEASURES: Spatiotemporal, kinematic, and kinetic parameters during gait analysis were analyzed before (E0) and 1 year after (E1) the surgery. For 22 children, a 2-year postoperative gait analysis (E2) took place as well. RESULTS: At E1, several kinematic and kinetic parameters improved, although there was no significant difference between the groups. Spatiotemporal parameters showed a worsening at E1 and a recovery to preoperative values at E2. CONCLUSIONS: The examined parameters may be more substantially influenced by factors such as the surgery outcome and the variability of pathologic characteristics than by the strength-training program per se. However, a more significant effect of the strength-training may appear if more intense and short-term training protocols are used, considering factors such as patients' motivations, ages, and postoperative statuses.

Adolescent↗

PubMed2006

Effects of a postoperative resistive exercise program on the knee extension and flexion torque in children with cerebral palsy: a randomized clinical trial.

OBJECTIVE: To investigate the effects of resistive exercise on the knee extension and flexion torque production during the rehabilitation period after multilevel orthopedic surgery. DESIGN: Randomized clinical trial. SETTING: Hospital rehabilitation department. PARTICIPANTS: Thirty-nine children with spastic diplegic cerebral palsy (CP) (age range, 6-16 y), randomly allocated to an exercise group (n=19) and a control group (n=20). All received conventional physiotherapy (PT), and the exercise group also followed a resistive exercise program. INTERVENTION: A 9-month standardized home-based resistive exercise program, which started about 3 months after the surgery. MAIN OUTCOME MEASURES: The Gross Motor Functional Measurement (GMFM) assessed before (E(0)) and 1 year (E(1)) after the surgery. The Modified Ashworth Scale and the isometric and isokinetic torque of the knee extensors and flexors were evaluated at E(0), E(1), and 6 months after the surgery. RESULTS: The knee extension and flexion moments had decreased 6 months after the surgery and recovered to the preoperative level 1 year after surgery. These changes were not group dependent. CONCLUSIONS: Additional long-term, home-based, low-cost resistive exercise that starts soon after the operation of patients with CP was not more beneficial than conventional PT only, in terms of strength and GMFM.

Adolescent↗

PubMed2006

Evans calcaneal lengthening procedure for spastic flexible flatfoot in 32 patients (46 feet) with a followup of 3 to 9 years.

BACKGROUND: The purposes of this study were to evaluate the outcome of calcaneal lengthening in severe pediatric flexible flatfoot deformities of spastic origin and to determine the necessity of additional procedures. METHODS: In a prospective study, 32 patients (46 feet) were evaluated clinically and radiologically. The mean age of patients was 11 (range 4 to 22) years. The mean period of followup was 66 (range 36 to 108) months. RESULTS: Additional soft-tissue procedures (Strayer procedure, peroneus lengthening, reefing medial capsule) were performed in 39 of 46 feet; other bony procedures were performed in eight. Among the 46 feet, 11 outcomes were classified as excellent, 19 as good, nine as fair, and seven as poor. Poor outcome was related to overcorrection in three and deformity relapse in four. Calcaneocuboid subluxation was seen in nine feet. Radiographic evaluation demonstrated an improvement of all parameters determined. CONCLUSION: The Evans procedure is effective for the correction of severe, flexible flatfoot deformity in children with cerebral palsy in the short and mid term. Additional soft-tissue procedures frequently are required. However, correction of this multiplanar deformity predominantly occurs in the forefoot abduction component of the deformity, and the concomitant naviculocuneiform sag remains uncorrected. Despite successful outcomes, overcorrection and undercorrection remains a problem of clinical relevance.

Adolescent↗

PubMed2005

Automated feature assessment in instrumented gait analysis.

A methodological modular framework is presented for automated assessment of gait patterns. The processing steps of data selection, gait parameter calculation and evaluation are not limited to a specific field of application and are largely independent of case-based clinical expert knowledge. For these steps, a variety of mathematical methods was used and the validity of the approach to assess gait parameters tested by applying it to the clinical problem of Botulinum Toxin A (BTX-A) treatment of the spastic equinus foot. A set of 3670 parameters was ranked by relevance for classification of a group of 42 diplegic cerebral palsy (CP) patients and an age-matched reference group. The same procedure was performed for pre- and post-therapeutic data sets of these patients. Gait parameters of high relevance coincided well with results of previous studies based on partly manual and more subjective parameter selection. A norm distance measure is introduced to facilitate the quantification of deviations from a normal walking pattern and can be used as an overall scalar measure to evaluate differences in gait patterns or as a set of measures attributing each joint angle separately.

Automation↗

PubMed2004

A comparison of the grip force distribution in natural hands and in prosthetic hands.

PURPOSE: The aim of this study is to analyse the grip force distribution for different prosthetic hand designs and the human hand fulfilling a functional task. METHOD: A cylindrical object is held with a power grasp and the contact forces are measured at 20 defined positions. The distributions of contact forces in standard electric prostheses, in a experimental prosthesis with an adaptive grasp, and in human hands as a reference are analysed and compared. Additionally, the joint torques are calculated and compared. RESULTS: Contact forces of up to 24.7 N are applied by the middle and distal phalanges of the index finger, middle finger, and thumb of standard prosthetic hands, whereas forces of up to 3.8 N are measured for human hands. The maximum contact forces measured in a prosthetic hand with an adaptive grasp are 4.7 N. The joint torques of human hands and the adaptive prosthesis are comparable. CONCLUSIONS: The analysis of grip force distribution is proposed as an additional parameter to rate the performance of different prosthetic hand designs.

Adolescent↗

PubMedDate not supplied

Femoral derotation.

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Child↗