Article

Fine wire electromyography (EMG) is commonly used for surgical
decision making in equinovarus foot deformity. However, this invasive technique
may have the unwanted effect of altering the gait of children with cerebral palsy (CP). The purpose of this study was to determine if fine wire insertion into the
posterior tibialis muscle affects temporal-spatial parameters and hindfoot
kinematics during gait in children with equinovarus secondary to hemiplegic CP.
METHODS: 12 children with hemiplegic CP who presented with an equinovarus foot
(mean age 12.5 yrs, four right-sided, eight left-sided) were recruited.
Temporal-spatial parameters and 3-D segmental foot and ankle kinematic gait data
were collected utilizing standard gait analysis and the Milwaukee Foot Model
(MFM). Three representative trials with and without fine wire electrode insertion
were compared to determine the effect of electrode placement in the posterior
tibialis on temporal spatial-parameters and hindfoot sagittal, coronal and
transverse plane kinematic peaks, timing of kinematic peaks, and excursions.
RESULTS: No significant differences in any temporal-spatial or kinematic
parameters were observed between "with wire" and "without wire" conditions.
Strong correlations were observed among the gait parameters, with the exception
of cadence, for the two conditions. DISCUSSION:
Fine wire insertion into the
posterior tibialis had no measurable effect on the gait of individuals with
equinovarus secondary to hemiplegic CP. This suggests that the simultaneous
collection of segmental foot and ankle kinematics and fine wire EMG data of the
posterior tibialis is acceptable for surgical decision making in this patient population.
CI - Copyright (c) 2012 Elsevier B.V. All rights reserved.

Langue : ANGLAIS