Abstract
BackgroundThree-dimensional gait analysis (3DGA) is commonly used to assess the effect of orthopedic single-event multilevel surgery (SEMLS) in children with spastic cerebral palsy (CP).PurposeThe purpose of this systematic review is to provide an overview of different orthopedic SEMLS interventions and their effects on 3DGA parameters in children with spastic CP.MethodsA comprehensive literature search within six databases revealed 648 records, from which 89 articles were selected for the full-text review and 24 articles (50 studies) included for systematic review. The Oxford Centre for Evidence-Based Medicine Scale and the Methodological Index for Non-Randomized Studies (MINORS) were used to appraise and determine the quality of the studies.ResultsExcept for one level II study, all studies were graded as level III according to the Oxford Centre for Evidence-Based Medicine Scale. The MINORS score for comparative studies (n = 6) was on average 15.7/24, while non-comparative studies (n = 18) scored on average 9.8/16. Nineteen kinematic and temporal-distance gait parameters were selected, and a majority of studies reported improvements after SEMLS interventions. The largest improvements were seen in knee range of motion, knee flexion at initial contact and minimal knee flexion in stance phase, ankle dorsiflexion at initial contact, maximum dorsiflexion in stance and in swing phase, hip rotation and foot progression angles. However, changes in 3DGA parameters varied based on the focus of the SEMLS intervention.DiscussionThe current article provides a novel overview of a variety of SEMLS interventions within different SEMLS focus areas and the post-operative changes in 3DGA parameters. This overview will assist clinicians and researchers as a potential theoretical framework to further improve SEMLS techniques within different SEMLS focus groups. In addition, it can also be used as a tool to enhance communication with parents, although the results of the studies can’t be generalised and a holistic approach is needed when considering SEMLS in a child with spastic CP.
Highlights
Gait abnormalities are common in children with cerebral palsy (CP) and are generally caused by an abnormal muscle tone, loss of motor control and balance problems due to a non-progressive lesion of the developing brain [1]
The finding of this study showed that 3-dimensional gait analysis (3DGA), and kinematic and temporal-distance parameters, are most commonly used to assess the effectiveness of single-event multilevel orthopedic surgery (SEMLS) interventions
A systematic review of these SEMLS outcome studies can provide valuable insight for clinicians, can assist in preoperative discussion with parents and form a platform to potentially further improve SEMLS techniques the aim of this study is to provide a systematic overview of which soft tissue and bony interventions have been performed as part of SEMLS intervention in children with CP, with a special focus on the post-operative changes in 3DGA kinematic and temporal-distance parameters
Summary
Gait abnormalities are common in children with cerebral palsy (CP) and are generally caused by an abnormal muscle tone, loss of motor control and balance problems due to a non-progressive lesion of the developing brain [1]. Several complementary interventions are often used to develop the most optimal and energy efficient gait pattern in these children. These interventions range from physical and occupational therapy, neurosurgical and pharmacological interventions to reduce hypertonia and orthopedic interventions aiming to restore anatomical structures and musculoskeletal conditions [3]. As a multi-level approach has proven to be the most effective treatment option, it is not surprising that within orthopedics, single-event multilevel orthopedic surgery (SEMLS) is the preferred method to treat musculoskeletal deformities in children with CP [3,4]. Three-dimensional gait analysis (3DGA) is commonly used to assess the effect of orthopedic single-event multilevel surgery (SEMLS) in children with spastic cerebral palsy (CP). The purpose of this systematic review is to provide an overview of different orthopedic SEMLS interventions and their effects on 3DGA parameters in children with spastic CP
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
