ABSTRACT
Van Nes rotationplasty may be used for patients with congenital proximal focal femoral deficiency (PFFD). The lower limb is rotated to use the ankle and foot as a functional knee joint within a prosthesis. A small series of cases was investigated to determine the long-term outcome. At a mean of 21.5 years (11 to 45) after their rotationplasty, a total of 12 prosthetic patients completed the Short-Form (SF)-36, Faces Pain Scale-Revised, Harris hip score, Oswestry back pain score and Prosthetic Evaluation Questionnaires, as did 12 age- and gender-matched normal control participants. A physical examination and gait analysis, computerised dynamic posturography (CDP), and timed 'Up & Go' testing was also completed. Wilcoxon Signed rank test was used to compare each PFFD patient with a matched control participant with false discovery rate of 5%. There were no differences between the groups in overall health and well-being on the SF-36. Significant differences were seen in gait parameters in the PFFD group. Using CDP, the PFFD group had reduced symmetry in stance, and reduced end point and maximum excursions. Patients who had undergone Van Nes rotationplasty had a high level of function and quality of life at long-term follow-up, but presented with significant differences in gait and posture compared with the control group.
Subject(s)
Ectromelia/surgery , Femur/abnormalities , Leg Length Inequality/surgery , Orthopedic Procedures/methods , Adolescent , Adult , Child , Female , Femur/surgery , Follow-Up Studies , Humans , Leg Length Inequality/congenital , Male , Middle Aged , Orthopedic Procedures/adverse effects , Quality of Life , Range of Motion, Articular , Surveys and Questionnaires , Treatment Outcome , Young AdultABSTRACT
This study uses experimental data acquired from adolescents with idiopathic scoliosis to assess their postural control during quiet standing before and after posterior spinal fusion. Statistically significant differences were seen when comparing the pre- and post-surgical measures of balance calculated from data for three different test conditions.
Subject(s)
Postural Balance/physiology , Scoliosis/surgery , Spinal Fusion , Adolescent , Female , Humans , Male , Outcome Assessment, Health CareABSTRACT
This study examines the postural stability of children with idiopathic scoliosis, using experimental data and a model of sway that includes mediolateral (ML) and anterioposterial (AP) components. The experimental data includes center of pressure (COP) measurements calculated from data acquired using two Advanced Medical Technology, Inc. (AMTI) force plates. Sway metrics are computed and compared with the model simulation, which successfully reproduced the clinical data from 16 children with scoliosis and 20 typically-developing children. This study is part of the first phase of a multi-year study designed to systematically assess whether fusing the spine to L4 in children with scoliosis has a significant impact on physical function and quality of life.
Subject(s)
Models, Biological , Postural Balance/physiology , Scoliosis/physiopathology , Adolescent , Biomechanical Phenomena , Biomedical Engineering , Case-Control Studies , Child , Female , Humans , Lumbar Vertebrae/surgery , Male , Scoliosis/surgery , Spinal FusionABSTRACT
This study presents initial results from a bi-planar model used to investigate the neurological factors affecting balance deficits in children with diplegic cerebral palsy (CP). The model uses an inverted pendulum to describe sway in both the anteroposterior (AP) and mediolateral (ML) planes. The study presents Center of Pressure (COP) data from 17 children diagnosed with spastic diplegic CP using two standard AMTI force plates. Sway metrics in the time and frequency domains in the AP and ML planes were calculated and compared to simulations produced by the model. The proposed bi-planar model successfully reproduced sway signals acquired from experimental (clinical) data.
