Leonhard Döderlein's research while affiliated with University of Oxford and other places
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Publications (247)
Wer sich mit den Formveränderungen des Kinderfußes befassen will, muss sich auch mit seiner Entwicklung und den vielfältigen Anforderungen an seine Funktion sowie an die im Verlaufe der Reifung wechselnden Erscheinungsformen beschäftigen. Nur wenn man sich dem wachsenden Fuß mehrdimensional widmet, lernt man abzuschätzen, was einerseits noch als ph...
Introduction
The flexible spastic varus foot in cerebral palsy is commonly corrected by split-tendon transfer of tibialis anterior or tibialis posterior. These tendon transfers are said to preserve hindfoot motion which is until now not been proven. Therefore, the aim of the study was to show the hindfoot motion following split-tendon transfer in c...
The objective of the study is to identify and evaluate possible factors that influence the
ability to run before and after single event multi-level surgery (SEMLS). Young patients (6–25 years)
with spastic cerebral palsy (GMFCSI-II) were retrospectively included. Type and number of surgical
procedures, time for recovery and 3D gait analysis variabl...
Operationen zur Korrektur von drohenden oder von voll ausgebildeten Fußdeformitäten haben einen hohen Stellenwert im orthopädischen Behandlungskonzept. Die wichtige Bedeutung des Fußes im Rahmen der Steh- und Gehfunktionen und vor allem das bei neuroorthopädischen Störungen vorliegende Missverhältnis zwischen einer einwirkenden Belastung und der da...
Complex deformities around the knee joint are usually severe and have several aetiologies. They can be present in one or more planes, with variations in severity between planes. The occurrence and progression of the deformity can be influenced by local and systemic factors. Several types of osteotomies and fixation methods are available to correct...
Congenital joint stiffness (arthrogryposis multiplex congenita; AMC; amyoplasia) and congenital or acquired muscle spasticity (spastic cerebral palsy (SCP); unilateral or bilateral spastic cerebral palsy, spastic paresis) represent two characteristic paralytic disorders of the upper extremity. Patients with AMC have normal sensitivity and proprioce...
In diesem zweiten Teil zur Druckverteilung beim Gehen von Kindern und Jugendlichen wurden symptomatische und asymptomatische Knick-Senkfüße sowie eine Kontrollgruppe mit unauffälligen Füßen mit dem Fokus auf die Belastungsanalyse des Vorfußes untersucht. Mit einer EMED Messplatte wurden 58 symptomatische, 40 asymptomatische Knick-Senkfüße und 42 kl...
Objective:
Aim of the investigation was to assess the contribution of pain to functional, social, and health-related quality of life (Qol) outcomes in adults with cerebral palsy.
Design:
This monocentric, prospective study included long-term data for ambulant adults with cerebral palsy and at level I to III in the Gross Motor Function Classifica...
Mit dieser Studie wurde überprüft, ob die Aspekte der Druckverteilung des kindlichen Knick-Senkfußes in den AWMF-Leitlinien, symptomatische von asymptomatischen Knick-Senkfüßen differenzieren können. Übergeordnetes Ziel ist es, die bisher unbefriedigenden, subjektiven Kriterien für den Therapiebedarf bei Kindern und Jugendlichen durch funktionelle,...
Introduction
Shortening of the tibialis anterior tendon (TATS) has been shown to improve the ankle dorsiflexion in swing following the calf muscle lengthening procedure (CMLP) in patients with cerebral palsy (CP). Others have reported the similar improvements following CMLP but without TATS. However there are no studies comparing both procedures. T...
Die Begriffe Coxa valga und Coxa vara bezeichnen eine Vergrößerung bzw. eine Verkleinerung des physiologischen Winkels zwischen dem Schenkelhals und dem Femurschaft. Bei der Coxa antetorta vergrößert sich die physiologische Verdrehung zwischen dem Schenkelhals und dem Femurschaft nach vorne; bei der Coxa retrotorta fehlt diese Verdrehung bzw. ist s...
Background
Foot-drop is a common impairment in individuals with upper motor neuron syndrome. It may cause walking instability, and greater risk of tripping and falling. Ankle–foot orthoses are the standard of care for foot-drop, but may constrain ankle movement and limit function. Functional electrical stimulation (FES) was shown to be a less restr...
Zusammenfassung
Zahlreiche zentrale und periphere neuromuskuläre Störungen können mit einer Klumpfuß-deformität assoziiert sein. Stationäre und progrediente Erkrankungen führen über ein spezifisches Muskelungleichgewicht zu anfangs flexiblen aber im weiteren Verlauf meist kontrakten Klumpfüssen. Die Diagnostik muß immer neben der Fußproblematik auc...
Background:
Overcorrection is a recognized problem following surgical treatment of congenital clubfoot. Recently this complication has also been mentioned following Ponseti treatment.
Research question:
Do overcorrected clubfeet (OCCF) caused by surgery behave differently from those caused by Ponseti treatment in terms of segmental motion of the...
Abstract
Background
There is considerable debate as to which parameters to include in the assessment of paediatric flatfeet. Dynamic pedobarography is an objective, dynamic method to measure foot function. Information about its associations to patient-reported measures may help to focus on the most relevant parameters.
Research Question
What is the...
Background:
Idiopathic flexible flatfeet, congenital clubfeet and pes cavovarus are the most common foot deformities in children. Accurate assessment to quantify the severity of these deformities by clinical examination alone can be challenging. Radiographs are a valuable adjunct for accurate diagnosis and effective treatment. However, static radi...
Introduction:
The paediatric flexible flatfoot constitutes the major cause of clinic visits for orthopaedic foot problems. It shows variations of deformities in different planes and locations of the foot and its indication for treatment have been extensively discussed. Despite its high prevalence there exists no classification of flatfeet during w...
Background
Classification of sagittal gait patterns in unilateral spastic cerebral palsy (CP) provides direct implication for treatment. Five types are described: type 0 has minor gait deviation; type 1 has inadequate ankle dorsiflexion in swing; type 2 has inadequate ankle dorsiflexion throughout the gait cycle; types 3 and 4 have abnormal functio...
Foot drop is a common finding in cerebral palsy and may be associated with foot drop. According to the literature, the shortening of Tibialis anterior would improve the active dorsiflexion of the ankle Joint. However the studies in the literature do not provide any control groups. We conducted a study both in hemiplegics and diplegics where tibiali...
Background:
Patients with spastic Cerebral Palsy are prone to equinus deformities, likely affected by short and inextensible plantarflexor muscles. Manual stretching is a popular treatment but its effectiveness concerning joint mobility, muscle-tendon morphometrics and walking function is debated. Eccentric exercise by backward-downhill treadmill...
Background:
Running is a fundamental movement skill and a prerequisite for children to participate in numerous daily activities. The prevalence of the ability to run in people with Cerebral Palsy and the role of their impairments on running ability are unknown. Therefore, the aim of this study is to determine the prevalence of the ability to run a...
Background:
Deterioration of gait in adolescent and adult patients with cerebral palsy can be associated with multiple factors. Multilevel surgery (MLS) is one option in adults with cerebral palsy to improve gait function with encouraging short-term results. It is a question whether these improvements are maintained over time.
Methods:
In a retr...
Auffälligkeiten der kindlichen Entwicklung („motorische Meilensteine“), Fehlstellungen der Beine, Einschränkungen der Beweglichkeit, aber auch Schmerzen führen Kinder zum Kinderorthopäden, wie auch die Behandlung des Klumpfußes, der Skoliose, neurologischer Krankheitsbilder (Spastik, Spina bifada, Arthrogrypnose) sowie die Versorgung mit Orthesen (...
Background:
Equinus foot deformity constitutes a common gait disorder in ambulatory adults with bilateral spastic cerebral palsy (BSCP). The outcome after intramuscular aponeurotic lengthening in the context of single-event multilevel surgery (SEMLS) in adulthood has not been investigated.
Methods:
We followed a group of 31 ambulatory adults wit...
Der Klumpfuß zählt zu den am stärksten funktionseinschränkenden Rückfußdeformitäten. Er ist durch typische Veränderungen der Stellung der Rück- und Vorfußgelenke zueinander charakterisiert. Die Diagnostik hat die einzelnen Bestandteile der Deformität durch klinische Tests und eine geeignete Bildgebung zu klassifizieren. Die Auswahl der Therapie ric...
Aim:
We investigated the long-term efficacy and safety of multilevel surgery (MLS) in ambulatory children with bilateral spastic cerebral palsy (CP).
Method:
Two hundred and thirty-one children were evaluated at short term (1.1y, SD 0.4) and long term (9.1y, SD 3.0) follow-up using clinical examination and gait analysis. MLS was investigated by...
Background:
Patella-alta is very common in patients with Cerebral Palsy (CP). While several diagnostic x-ray indices have been developed for patella-alta in general, the specific relationship with walking dysfunction in CP is only partly understood.
Methods:
33 participants with bilateral spastic CP between 4 and 20 years (GMFCS I-II without pre...
Aims:
A flexed knee gait is common in patients with bilateral spastic cerebral palsy and occurs with increased age. There is a risk for the recurrence of a flexed knee gait when treated in childhood, and the aim of this study was to investigate whether multilevel procedures might also be undertaken in adulthood.
Patients and methods:
At a mean o...
Background:
Floor reaction ankle-foot orthoses are commonly prescribed to improve knee extension of children with cerebral palsy having crouch gait. Their effectiveness is debated. Therefore, the objective of this study is to optimize current prescription criteria for the improvement of crouch gait.
Study design:
Cross-sectional interventional s...
Background:
Equinovalgus deformity is the second most common deformity in cerebral palsy and may be flexible or rigid. Several operative methods from joint sparing to arthrodesis have been described with varying success rates. The aim of this study was to investigate the effectiveness of naviculectomy in combination with midfoot arthrodesis (talo-...
Introduction:
Patellar tendon shortening procedure within single event multilevel surgeries was shown to improve crouch gait in Cerebral Palsy (CP) patients. However, one of the drawbacks associated to the correction of flexed knee gait may be increased pelvic anterior tilt with compensatory lumbar lordosis.
Research question:
Which CP patients...
Foot motion and plantar-pressure measures gained widespread popularity in the evaluation of pediatric flatfeet [FF]. For the clinician, there is a need to examine and connect complaints, such as pain and perceived disability with objective measures to gain knowledge about causal relationships and initiate treatment with improved certainty. Our aim...
Idiopathic pes planovalgus (PPV) is considered physiological in toddlers. Despite this fact, many
children with a normal static foot shape are provided with shoe inserts or even orthotic devices [1,
2]. The aim of this pilot study is to test the hypothesis that recommendations for conservative
treatment in toddlers with PPV are still too subject...
Die beiden charakteristischen Lähmungsbilder der angeborenen Gelenksteife (auch Arthrogrypose oder Amyoplasie genannt) und der meist erworbenen Spastik gehen mit typischen klinischen Erscheinungsbildern an der oberen Extremität einher. Patienten mit einer Arthrogrypose verfügen über eine normale Sensibilität und Propriozeption. Bei der spastischen...
Background:
Internal rotation gait constitutes a complex gait disorder in bilateral spastic cerebral palsy (BSCP) including static torsional and dynamic components resulting in lever arm dysfunction. Although femoral derotation osteotomy (FDO) is a standard procedure to correct increased femoral anteversion in children, unpredictable outcome has b...
Background:
Plantarflexor tightness due to muscle degenerations has been frequently documented in children with spastic cerebral palsy but the contractile behavior of muscles during ambulation is largely unclear. Especially the adaptability of gastrocnemius muscle contraction on sloped surface could be relevant during therapy.
Methods:
Medial ga...
Background
The apophysis of the calcaneal bone forms an insertional region for the strong plantarflexors with the Achillis tendon and serves as an origin for the plantar aponeurosis and the short intrinsic foot muscles. Both components create a tendinous sling whithin which the apophysis acts as a pivot, which functions when it runs a straight cour...
Die Dysplasie und die Luxation des Hüftgelenks sind morphologische Entitäten von unterschiedlichem Schweregrad. In der französischen Sprache werden sie als „maladie luxante de la hanche“ und im angloamerikanischen Raum als „developmental dysplasia of the hip“ bezeichnet, was den dynamischen bereits intrauterin beginnenden Prozess der Hüftreifungsst...
Derotation osteotomies of the femur and tibia are established procedures to improve transverse plane deformities during walking with inwardly pointing knees and in- and out toeing gait. However, effects of femoral derotation osteotomies on gait were reported to be small, and those for the tibia are not known. Therefore, the aim of the study was to...
Die Begriffe Coxa valga und Coxa vara bezeichnen eine Vergrößerung bzw. eine Verkleinerung des physiologischen Winkels zwischen dem Schenkelhals und dem Femurschaft.
Aims:
Single-event multilevel surgery (SEMLS) has been used as an effective intervention in children with bilateral spastic cerebral palsy (BSCP) for 30 years. To date there is no evidence for SEMLS in adults with BSCP and the intervention remains focus of debate.
Methods:
This study analysed the short-term outcome (mean 1.7 years, standard devi...
Femoral derotation osteotomy (FDO) as gold standard treatment for internal rotation gait in cerebral palsy (CP) leads to satisfying short-term results, whereas rates of recurrence up to 33% are reported in long-term outcome studies. The purpose of this study was therefore to identify factors contributing to recurrence of internal rotation gait in p...
Malaligned knees are predisposed to the development and progression of unicompartmental degenerations because of the excessive load placed on one side of the knee. Therefore, guided growth in skeletally immature patients is recommended. Indication for correction of varus/valgus deformities are based on static weight bearing radiographs. However, th...
In children with cerebral palsy (CP), braces are used to counteract progressive joint and muscle contracture and improve function. We examined the effects of positional ankle-foot braces on contracture of the medial gastrocnemius (MG) and gait in children with CP while referencing to typically developing children.
Seventeen independently ambulant c...
Die Wirbelsäule spielt abhängig vom Behinderungsgrad der Patienten eine zunehmend wichtige Rolle. Eine stabile aufrechte Sitzposition ist die Grundlage für eine adäquate Förderung von stärker behinderten Betroffenen. Wirbelsäulendeformitäten entwickeln sich ähnlich wie Hüftgelenkprobleme progredient, wenn nicht rechtzeitig eingegriffen wird, und sc...
Die Bedeutung der oberen Extremität bei der Zerebralparese ergibt sich durch die mannigfachen Möglichkeiten ihrer Deformierung, die zu progredienten funktionellen und kosmetischen und bei den stärker Behinderten auch zu pflegetechnischen Einbußen führt. Betroffen sind Patienten mit spastischer unilatealer Parese und die stärker Behinderten mit bila...
Die Diagnosestellung der Zerebralparese lässt sich in Frühdiagnostik und Diagnostik der manifesten Zerebralparese trennen. Seit Langem bemüht man sich, exakte Prädiktoren zu entwickeln, die das Risiko eines Neugeborenen eine Zerebralparese zu entwickeln ausreichend sicher vorhersagen können. Dies wäre nicht nur für die Betroffenen, sondern auch für...
Die Indikationsstellung zur Behandlung der Zerebralparese stellt angesichts der Vielzahl möglicher invasiver und nichtinvasiver Behandlungsverfahren die höchsten Anforderungen an den Arzt. Um den subjektiven Faktor bei der Indikationsstellung möglichst gering zu halten, ist ein standardisiertes Programm wie z. B. das von David Scrutton vorgeschlage...
Die detaillierte Darstellung der einzelnen Operationstechniken, die uns aktuell für die Behandlung der Zerebralparese zur Verfügung stehen, bildet einen zentralen Pfeiler im Therapiekapitel. Durch genaue Informationen zum Operationsprinzip, zur Indikationsstellung, zur Vorbereitung des Patienten, zur Technik und zur Nachbehandlung sowie zu den Beso...
Der aufrechte bipedale Gang erlaubt den freien Gebrauch der oberen Extremitäten. Allerdings ist er wegen des hoch liegenden Körperschwerpunktes besonders instabil und deshalb an ein äußerst komplexes und dennoch automatisiert ablaufendes Zusammenspiel der Nerven-, Skelett- und Muskelfunktionen beider Beine und des Rumpfes angewiesen. Das zentrale N...
Der Fuß steht bei der Zerebralparese neben dem Hüftgelenk im Vordergrund der Probleme am
Bewegungsapparat. Er ist beim Steh- und Gehfähigen großen deformierenden Schub- und Scherkräften
ausgesetzt. Jede Fehlstellung der proximalen Gelenke wirkt sich immer auch auf die Fußstellung zum Untergrund
aus. Beim schwerer Behinderten unterliegt das Fußskele...
Jedes Kind und jeder Jugendliche mit Zerebralparese wird zum Erwachsenen mit Zerebralparese, der mit den lebenslang fortbestehenden Auswirkungen seines Gehirnschadens weiterleben muss. Angesichts der Tatsache, dass sich bisher fast ausschließlich Kinderorthopäden mit diesem Krankheitsbild beschäftigt haben und die Patienten damit jenseits des 16.–1...
Die verschiedenen Behandlungsmethoden haben unterschiedliche Wirkungsbereiche, die man für die Auswahl jeweils geeigneter Verfahren kennen sollte und die sich von motorischen Funktionseinschränkungen der Kopfmotorik über Schmerzen am Bewegungsapparat bis hin zu mentalen Defiziten erstrecken. Die Wirkungsweise der verschiedenen konservativen und ope...
Jede Diagnostik und Therapie pathologischer Zustände muss auf der normalen menschlichen Entwicklung aufbauen. Für die Beschäftigung mit der Zerebralparese sind Kenntnisse der Entwicklung des Bewegungsapparates und des Nervensystems entscheidend. Die physiologische Skelettentwicklung vollzieht sich in festgelegten Schritten, die durch äußere oder in...
Der Sammelbegriff der infantilen Zerebralparese beschreibt eine Störung von Haltung und Bewegung sowie von psychischen und vegetativen Funktionen, die infolge einer dauerhaften Schädigung des unreifen Gehirnes entsteht. Das Ausmaß der zentralen Schädigung, aber auch Wachstums- und Entwicklungseinflüsse bestimmen das jeweilige Schädigungsbild, das s...
Unser aktuelles Wissen um die Besonderheiten der Zerebralparese wirft nach wie vor viele weitere Fragen auf, die bisher unbeantwortet blieben. Die Möglichkeit der Prävention von Deformitäten, mit denen wir uns mit unverändert aufwendigen Behandlungsmaßnahmen herumquälen, steht dabei ebenso im Zentrum wie die Entstehung der Deformitäten auf feingewe...
Im Anhang werden verschiedene Bögen zur Diagnostik und Klassifikation der Probleme am Bewegungsapparat vorgestellt. Diese Unterlagen sollen als Anregung verstanden werden, sich eine eigene Systematik für die Diagnosestellung und Behandlung der betroffenen Patienten zu entwickeln. Verschiedene Klassifikationen hinsichtlich der Schweregrade sind dabe...
Jede Therapie trägt – auch wenn sie gut indiziert und durchgeführt wurde – ein gewisses Risiko in sich. Dies gilt naturgemäß besonders für die operativen Behandlungsverfahren. An erster Stelle steht die Rezidivgefahr. Das Wachstum und die damit verbundene Größen- und Gewichtszunahme können jede anfangs geglückte operative Korrektur wieder zunichtem...
Das Kniegelenk spielt eine zentrale Rolle beim spastisch-pathologischen Gang. Wegen der langen Hebelarme zieht jede Kniegelenkdeformität charakteristische Gangstörungen nach sich, die, wenn sie einseitig sind, immer auf der Gegenseite kompensiert werden müssen. Unter den Pathomechanismen stehen die pathologische Musteraktivität und die Muskelschwäc...
Die Behandlungsverfahren der Zerebralparese lassen sich grob in nichtinvasive und invasive Methoden unterteilen. Hinzu kommen sog. Außenseiter- oder paramedizinische Verfahren, die aber in ihrer Wirksamkeit umstritten sind. Zu den nichtinvasiven Techniken gehören Physiotherapie und Ergotherapie, Orthopädie- und Rehatechnik, physikalische Therapie s...
Nahezu jeder gehfähige Patient mit infantiler Zerebralparese zeigt eine spezifische Gangstörung, die unterschiedlich stark ausgeprägt sein und sich im Verlauf auch ändern kann. Das auffällige Gangbild stellt die Summe von Defiziten der zentralen Steuerung, pathologischen Veränderungen am Haltungs- und Bewegungsapparat (Muskel- und Skelettsystem mit...
Internal rotation gait is common among children with bilateral cerebral palsy. However, despite bilaterally increased femoral anteversion asymmetric internal rotation gait is often found. Femoral derotation osteotomy (FDO) is commonly performed bilaterally. Variable functional outcomes are reported especially in cases with mild internal hip rotatio...
Background: Adolescents with cerebral palsy often complain about a Duchenne gait, which increases the load on the spine, the energy consumption and therefore decreases gait efficiency. However the underlying causes of a Duchenne gait in patients with CP are not clearly researched yet. Nevertheless there is an assumption that excessive trunk lean mi...
Climbing therapy combines the challenge of height with strength, flexibility and coordination training. The typical climbing posture with abducted and external rotated hips, extended knees and ankle dorsiflexion might be ideally suited to improve typical intoeing, crouch and equinus gait pathologies in cerebral palsy. Therefore, the objective was t...
The femoral derotation osteotomy (FDO) is seen as the golden standard treatment in children with cerebral palsy and internal rotation gait. Variable outcomes with cases of over- and undercorrection mainly in the less involved patients have been reported. The determination of the amount of derotation is still inconsistent. 138 patients (age: 11(±3.3...
Background:
As developmental dysplasia of the hip (DDH) is the most common congenital muskuloskeletal anomaly, it seems necessary to give an update on the normal growth, pathoanatomy, diagnostic and therapeutic procedures.
Objectives:
Which investigations or procedures have withstood the test of time? What are new therapeutic strategies and cons...
Flaccid paralysis is the result of many different causes presenting with a multitude of symptoms ranging from affecting only the efferent pathways up to involvement of both the afferent and efferent loops of the peripheral neuoromotor system. The peripheral distribution corresponds to the damage. The functional limitations of flaccid paralysis are...
Background: Varus knee alignment has been identified as a risk factor for the progression of medial knee osteoarthritis (OA). This study tested the hypothesis that not only frontal plane kinematics and kinetics but also transverse plane lower extremity mechanics during gait are affected by varus malalignment of the knee.
Methods: Eighteen, otherwis...
Patients with cerebral palsy frequently experience foot dragging and tripping during walking due to reduced toe clearance mostly caused by a lack of adequate knee flexion in swing (stiff-knee gait). The aim of this study was to investigate adaptive mechanism to an uneven surface in stiff-knee walkers with cerebral palsy. Sixteen patients with bilat...
Ipsilateral trunk lean toward the affected stance limb has been identified as a compensatory mechanism to unload the hip joint. However, this altered gait pattern increases the lever arm around the knee joint by shifting the ground reaction vector more lateral to the knee joint center, which could be sufficient to deform the lateral compartment of...
The aim was to investigate the causes for pathological trunk movements during gait in children with Amyoplasia. Eighteen children with Amyoplasia were compared with 18 typically developed children. Three-dimensional motions of pelvis, thorax and spine during gait were analyzed. Excessive trunk movements were defined as being above 4 standard deviat...
Introduction:
Distal rectus femoris tendon transfer is the standard surgical procedure for the treatment of stiff-knee gait in patients with cerebral palsy and is commonly performed during single-event multilevel surgery.
Step 1 positioning and approach:
With the patient supine, make a 3 to 4-cm longitudinal incision 2 to 3 cm above the patellar...
The standard Plug-in-Gait (PiG) protocol used in three-dimensional gait analysis is prone to errors arising from inconsistent anatomical landmark identification and knee axis malalignment. The purpose of this study was to estimate the reliability and accuracy of a custom made lower body protocol (MA) compared to the PiG protocol. Twenty-five subjec...
Citations
... The original search yielded 546 records, of which 309 duplicates were removed, 245 underwent screening of title and abstract, 57 going through full-text review, and 20 subsequently included for review (Figure 1). Seven publications required additional data/information to confirm eligibility and for reporting, 7,9,14,19,[34][35][36] from which four were received, 7,9,14,36 and three were subsequently excluded (data unavailable from authors), 19,34,35 resulting in a total of 17 studies included for data extraction. Of these 17 studies, authors of nine studies reported or supplied subgroup data for the subgroups of participants with CP meeting our inclusion criteria. ...
... This procedure, performed in combination with GSL, may improve the function of the tibialis anterior muscle and hence improve ankle dorsiflexion during the swing phase of gait [28]. This has the potential to reduce the frequency of foot drop and obviate the need for long-term AFO use [29,30]. Retrospective cohort studies of the effectiveness of TATS have been published [28,29,31]. ...
... Hence, FES has great potential for improving foot posture in a flexible clubfoot deformation. The indication of FES use can even be extended to patients with dynamic clubfoot deformities in order to improve the repositioning of the clubfoot at initial contact [37]. ...
... Initially, the search strategy provided 1194 unique articles. After screening articles for inclusion and exclusion criteria, 20 studies met the criteria [24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42][43]. Articles were mainly excluded since the described clubfoot cohort was not treated with the Ponseti method, and no kinematic outcomes were reported ( Figure 1). ...
... К методам диагностики мобильной плоско-вальгусной деформации стоп относятся визуальный осмотр с проведением тестов мобильности стопы, подометрия и фотоплантография с расчетом индексов стопы, компьютерная педобарография для изучения биомеханической функции стопы. Проводят компьютерную томографию перед операцией для создания 3D-структуры стопы и оптимизации плана операции, а для оценки состояния мягких тканей (ахиллова сухожилия, пружинящей связки, сухожилия задней большеберцовой мышцы, подошвенной фасции) -магнитно-резонансную томографию или ультразвуковое исследование [15][16][17][18][19]. «Золотым стандартом» диагностики плоскостопия остается рентгенография стоп и голеностопных суставов в двух проекциях под нагрузкой с измерением множества параметров для определения степени тяжести плоско-вальгусной деформации стоп [20,21]. ...
... Bruinicks Oseretsky test), and as for the 6MWT, participants with cavus feet had the worst results. The foot type classification using the FPI occurs in a static condition; it may not reflect the foot's behavior in dynamic conditions, according to a study of radiological data and kinematics [33]. Another factor to be considered is that our study participants, unlike adults with CMT, are still developing their deformities. ...
... In recent years, there has been an increasing interest in foot interfaces [9]. For accurately detecting gait and related parameters, literature showcased a great number of technology approaches, which include the following sensors: Inertial Measurement Units (IMUs) for measuring movements, rotation, and angular velocity [18,22], Pressure sensors for measuring ground contact and calculating the center of pressure [11,12], Temperature and humidity sensors for monitoring diabetic foot ulceration [25,26], Strain gauges for recognizing stretch, bend, and changing pressure [5], Speed sensors for calculating physical forces [19], GPS for tracking location, height differences, speed, and distance, Capacitive sensors for detecting walking styles, foot gestures, and floor type [15,23], Infrared light sensors for measuring heat and blood flow, and detecting blood sugar [6,7,14], Microphone sensors for determining gait parameters [29,29] and Cameras for tracking of posture and gait, and detecting terrain [2,3,30]. ...
... Increased hip adduction moments, particularly during PSw, might be, on the one hand, the result of prolonged stance phase (indicated by vertical lines within the figures) and, on the other hand, due to pelvic obliquity caused by leg-length discrepancy (LLD). Our results are consistent with those previously reported [7,21,28,29]. Absolute values comparable to those encountered during our investigations were reported, though only considering sagittal joint kinematics and partial joint moments for the uninvolved limb [28,30]. Generally, the movement pattern of the sound limb was assumed to be the result of the secondary deviation of the involved limb and a strategy to provide increased stability in order to optimize gait [8,9,21]. ...
... Overall, the results presented in the current study could be used to optimize training regimes to improve FR capacity and contribute to evidence-based and fair classification for this parasport. 25 in individuals with CP has been widely discussed, but remains inconclusive [22][23][24][25] . Indeed, the relationship between these factors is complex 23 . ...
... Future trials are needed to estimate how much more (or less) effective eccentric training is than usual rehabilitation, and to determine its optimal dose-effect. Finally, we excluded trials using taskoriented exercises such as backward gait-training (Hosl et al., 2018), whose tend to influence motor control, skill, speed, endurance, and not only strength. Ballistic training offers opportunities but might be more suitable when the goal of training is to improve the rate of force production (Williams et al., 2019). ...