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Hemiparetik ve diparetik serebral palsili çocuklarda ayak ark esnekliklerinin ve kalkaneal pozisyonun değerlendirilmesi

Year 2015, Volume: 2 Issue: 1 - Volume: 2 Issue: 1, 8 - 14, 23.07.2016

Abstract

Amaç: Çalışmanın amacı, hemiparetik serebral palsili (SP) çocuklarda subtalar açı, ayak medial longitudinal ve anterior transvers ark esnekliklerini, etkilenen taraf ve etkilenmeyen tarafta değerlendirmek ve spastik diparetik SP’li çocuklarla karşılaştırmaktı. Yöntem: Çalışmaya yaşları 6-15 yıl arasında değişen 37 hemiparetik SP’li ve 32 diparetik SP’li çocuk dahil edildi. Medial longitudinal ark esnekliği navikülar düşme testi ile değerlendirildi. Anterior transvers arkın esnekliği metatarsal genişlik ile hesaplandı. Subtalar açıları ölçüldü. Her iki gruptaki çocukların antropometrik ölçümleri ağırlık aktarmalı ve aktarmasız durumlarda ölçüldü. Bulgular: Hemiparetik SP’lilerde etkilenen ve etkilenmeyen taraf ark esnekliklerinde fark bulunmadı (p>0,05). Etkilenmeyen tarafta subtalar açı, etkilenen tarafa göre daha fazla bulundu (p0,05). Subtalar açı hemiparetik SP’lilerin etkilenen tarafında diparetiklere göre daha az bulunurken (p0,05). Tartışma: Bu çalışma, hemiparetik SP’lilerde ayak özelliklerinin her iki tarafta da benzer olabileceğini göstermiştir. Bu sonuçlar, SP’nin her iki klinik tipinde de subtalar açı değerlerinin, ayak yapısı için belirleyici olabileceğini düşündürmüştür. SP’nin farklı klinik tiplerinde ayak postürünün daha objektif yöntemlerle inceleneceği çalışmalara gereksinim vardır

References

  • Morrell DS, Pearson JM, Sauser DD. Progressive bone and joint abnormalities of the spine and lower extremities in cerebral palsy 1. Radiographics. 2002;22:257-268.
  • Binder H, Eng GD. Rehabilitation management of children with spastic diplegic cerebral palsy. Arch Phys Med Rehabil. 1989;70:482-489.
  • Kedem P, Scher DM. Foot deformities in children with cerebral palsy. Current opinion in pediatrics. 2015;27:67-74.
  • O'Connell PA, D'Souza L, Dudeney S, et al. Foot deformities in children with cerebral palsy. J Pediatr Orthop. 1998;18:743-747.
  • Fauconnier J, Dickinson HO, Beckung E, et al. Participation in life situations of 8-12 year old children with cerebral palsy: cross sectional European study. BMJ. 2009;338:b1458.
  • Wong L, Hunt A, Burns J, et al. Effect of foot morphology on center-of-pressure excursion during barefoot walking. J Am Podiatr Med Assoc. 2008;98:112-117
  • Nawoczenski DA, Ludewig PM. Electromyographic effects of foot orthotics on selected lower extremity muscles during running. ArchPhys Med Rehabil. 1999;80:540544.
  • Galli M, Cimolin V, Pau M, et al. Foot pressure distribution in children with cerebral palsy while standing. Res Dev Disabil. 2015;41:52-57.
  • Pauk J, Daunoraviciene K, Ihnatouski M, et al. Analysis of the plantar pressure distribution in children with foot deformities. Acta Bioeng Biomech, 2010;12:29-34.
  • Duffy C, Cosgrove A. (iii) The foot in cerebral palsy. Curr Orthop. 2002;16:104-113.
  • GMFCS: Gross Motor Functional Classification System: Available from: http://motorgrowth. canchild.ca/en/GMFCS/resources/TurkishGMFC SERFinal.pdf
  • Williams DS, McClay IS. Measurements used to characterize the foot and the medial longitudinal arch: reliability and validity. Phys Ther;80:864-871.
  • Morrison S, Durward B, Watt G, et al. The intra-rater reliability of anthropometric data collection conducted on the peripubescent foot: A pilot study. Foot. 2005;15:180-184.
  • Smith-Oricchio K, Harris BA. Interrater reliability of subtalar neutral, calcaneal inversion and eversion. J Orthop Sports Phys Ther. 1990;12:10-15.
  • Cavanagh P, Morag E, Boulton A, et al. The relationship of static foot structure to dynamic foot function. J Biomech. 1997;30:243-250.
  • Gilmour JC, Burns Y. The measurement of the medial longitudinal arch in children. Foot Ankle Int. 2001;22:493-498.
  • Sell KE, Verity TM, Worrell TW, et al. Two measurement techniques for assessing subtalar joint position: a reliability study. J Orthop Sports Phys Ther. 1994;19:162-167.
  • Brody DM. Techniques in the evaluation and treatment of the injured runner. Orthop Clin North Am. 1982;13:541-558.
  • Beckett ME, Massie DL, Bowers KD, et al. Incidence of Hyperpronation in the ACL Injured Knee: A Clinical Perspective. J Athl Train. 1992;27:58-62.
  • Mueller MJ, Host JV, Norton BJ. Navicular drop as a composite measure of excessive pronation. J Am Podiatr Med Assoc. 1993;83:198-202.
  • Nielsen RG, Rathleff MS, Simonsen OH, et al. Determination of normal values for navicular drop during walking: a new model correcting for foot length and gender. J Foot Ankle Res. 2009;2:12.
  • Picciano AM, Rowlands MS, Worrell T. Reliability of open and closed kinetic chain subtalar joint neutral positions and navicular drop test. J Orthop Sports Phys Ther. 1993;18:553-558.
  • Cheng JC, Leung SS, Leung AK, et al. Change of foot size with weightbearing. A study of 2829 children 3 to 18 years of age. Clin Orthop Relat Res. 1997;342:123-131.
  • Kadhim M, Miller F. Pes planovalgus deformity in children with cerebral palsy: review article. J Pediatr Orthop B. 2014;23:400-405.
  • Gurney B. Leg length discrepancy. Gait Posture. 2002;15:195-206.
  • Blake RL, Ferguson HJ. Correlation between limb length discrepancy and asymmetrical rearfoot position. J Am Podiatr Med Assoc 1993;83:625-633.

Assessment of flexibility of arches and calcaneal position of foot in children with hemiparetic and diparetic cerebral palsy

Year 2015, Volume: 2 Issue: 1 - Volume: 2 Issue: 1, 8 - 14, 23.07.2016

Abstract

Purpose: The purpose of the study was to assess of flexibility of medial longitudinal and anterior transverse arches and angle of subtalar joint, and to compare with unaffected side, and with diparetic cerebral palsy (CP) children with hemiparetic CP. Methods: Thirty-seven hemiparetic and 32 diparetic children ages between 6 and 15 years were included in to the study. Flexibility of medial longitudinal arch was assessed using navicular drop test. Flexibility of medial longitudinal arch was assessed using ratio of metatarsal width. Subtalar angles were measured. Anthropometric measurements were taken under weight and non-weight bearing conditions. Measurements were compared with in groups and effected and unaffected feet for hemiparetics, right and left feet for diparetics. Results: There were no differences between flexibility of arches of effected and unaffected feet in patients with hemiparetic CP (p>0.05). Subtalar angle was found to be greater in unaffected side, when compared to effected side (p<0.05). In addition, there were no differences in flexibility ratio of arches between hemiparetic and diparetic patients (p>0.05). Subtalar angle was greater in affected side of hemiparetics compared to the same side of diparetics (p<0.05), but subtalar angle in affected side of hemiparetics was similar to the same side of diparetics (p>0.05). Conclusion: This study demonstrated that flexibility of foot arches may be similar. Subtalar joint may have an important role in determining foot structure in both hemiparetic and diparetic patients. Further study is needed to investigate foot structure using objective methods in children with different types of CP

References

  • Morrell DS, Pearson JM, Sauser DD. Progressive bone and joint abnormalities of the spine and lower extremities in cerebral palsy 1. Radiographics. 2002;22:257-268.
  • Binder H, Eng GD. Rehabilitation management of children with spastic diplegic cerebral palsy. Arch Phys Med Rehabil. 1989;70:482-489.
  • Kedem P, Scher DM. Foot deformities in children with cerebral palsy. Current opinion in pediatrics. 2015;27:67-74.
  • O'Connell PA, D'Souza L, Dudeney S, et al. Foot deformities in children with cerebral palsy. J Pediatr Orthop. 1998;18:743-747.
  • Fauconnier J, Dickinson HO, Beckung E, et al. Participation in life situations of 8-12 year old children with cerebral palsy: cross sectional European study. BMJ. 2009;338:b1458.
  • Wong L, Hunt A, Burns J, et al. Effect of foot morphology on center-of-pressure excursion during barefoot walking. J Am Podiatr Med Assoc. 2008;98:112-117
  • Nawoczenski DA, Ludewig PM. Electromyographic effects of foot orthotics on selected lower extremity muscles during running. ArchPhys Med Rehabil. 1999;80:540544.
  • Galli M, Cimolin V, Pau M, et al. Foot pressure distribution in children with cerebral palsy while standing. Res Dev Disabil. 2015;41:52-57.
  • Pauk J, Daunoraviciene K, Ihnatouski M, et al. Analysis of the plantar pressure distribution in children with foot deformities. Acta Bioeng Biomech, 2010;12:29-34.
  • Duffy C, Cosgrove A. (iii) The foot in cerebral palsy. Curr Orthop. 2002;16:104-113.
  • GMFCS: Gross Motor Functional Classification System: Available from: http://motorgrowth. canchild.ca/en/GMFCS/resources/TurkishGMFC SERFinal.pdf
  • Williams DS, McClay IS. Measurements used to characterize the foot and the medial longitudinal arch: reliability and validity. Phys Ther;80:864-871.
  • Morrison S, Durward B, Watt G, et al. The intra-rater reliability of anthropometric data collection conducted on the peripubescent foot: A pilot study. Foot. 2005;15:180-184.
  • Smith-Oricchio K, Harris BA. Interrater reliability of subtalar neutral, calcaneal inversion and eversion. J Orthop Sports Phys Ther. 1990;12:10-15.
  • Cavanagh P, Morag E, Boulton A, et al. The relationship of static foot structure to dynamic foot function. J Biomech. 1997;30:243-250.
  • Gilmour JC, Burns Y. The measurement of the medial longitudinal arch in children. Foot Ankle Int. 2001;22:493-498.
  • Sell KE, Verity TM, Worrell TW, et al. Two measurement techniques for assessing subtalar joint position: a reliability study. J Orthop Sports Phys Ther. 1994;19:162-167.
  • Brody DM. Techniques in the evaluation and treatment of the injured runner. Orthop Clin North Am. 1982;13:541-558.
  • Beckett ME, Massie DL, Bowers KD, et al. Incidence of Hyperpronation in the ACL Injured Knee: A Clinical Perspective. J Athl Train. 1992;27:58-62.
  • Mueller MJ, Host JV, Norton BJ. Navicular drop as a composite measure of excessive pronation. J Am Podiatr Med Assoc. 1993;83:198-202.
  • Nielsen RG, Rathleff MS, Simonsen OH, et al. Determination of normal values for navicular drop during walking: a new model correcting for foot length and gender. J Foot Ankle Res. 2009;2:12.
  • Picciano AM, Rowlands MS, Worrell T. Reliability of open and closed kinetic chain subtalar joint neutral positions and navicular drop test. J Orthop Sports Phys Ther. 1993;18:553-558.
  • Cheng JC, Leung SS, Leung AK, et al. Change of foot size with weightbearing. A study of 2829 children 3 to 18 years of age. Clin Orthop Relat Res. 1997;342:123-131.
  • Kadhim M, Miller F. Pes planovalgus deformity in children with cerebral palsy: review article. J Pediatr Orthop B. 2014;23:400-405.
  • Gurney B. Leg length discrepancy. Gait Posture. 2002;15:195-206.
  • Blake RL, Ferguson HJ. Correlation between limb length discrepancy and asymmetrical rearfoot position. J Am Podiatr Med Assoc 1993;83:625-633.
There are 26 citations in total.

Details

Other ID JA64DT74AR
Journal Section Articles
Authors

Gözde Gür This is me

Burcu Dilek This is me

Yavuz Yakut This is me

Publication Date July 23, 2016
Submission Date July 23, 2016
Published in Issue Year 2015 Volume: 2 Issue: 1 - Volume: 2 Issue: 1

Cite

Vancouver Gür G, Dilek B, Yakut Y. Hemiparetik ve diparetik serebral palsili çocuklarda ayak ark esnekliklerinin ve kalkaneal pozisyonun değerlendirilmesi. JETR. 2016;2(1):8-14.