Use of a dynamic foot pressure index to monitor the effects of treatment for equinus gait in children with cerebral palsy.
The purpose of this study is to introduce and describe a newly developed index using foot pressure analysis to quantify the degree of equinus gait in children with cerebral palsy before and after injection with botulinum toxin. Data were captured preinjection and 12 weeks postinjection. Ten children aged 2(1/2) to 6(1/2) years took part (5 boys and 5 girls). Three of them had a diagnosis of spastic diplegia and 7 of congenital hemiplegia. In total, 13 limbs were analyzed. After orientation and segmentation of raw pedobarographic data, we determined a dynamic foot pressure index graded 0 to 100 that quantified the relative degree of heel and forefoot contact during stance. These data were correlated (Pearson correlation) with clinical measurements of dorsiflexion at the ankle (on a slow and fast stretch) and video observation (using the Observational Gait Scale). Pedobarograph data were strongly correlated with both the Observational Gait Scale scores (R = 0.79, P < 0.005) and clinical measurements of dorsiflexion on a fast stretch, which is reflective of spasticity (R = 0.70, P < 0.005). We demonstrated the index's sensitivity in detecting changes in spasticity and good correlation with video observations seems to indicate this technique's potential validity. When manipulated and segmented appropriately, and with the development of a simple ordinal index, we found that foot pressure data provided a useful tool in tracking changes in patients with spastic equinus.
Bennett
Damien
D
Central Remedial Clinic, Dublin, Ireland. damien.bennett@yahoo.co.uk
Walsh
Mike
M
O'Sullivan
Rory
R
Gallagher
Joseph
J
O'Brien
Tim
T
Newman
Christopher John
CJ
D019274:Botulinum Toxins, Type A / Q000008:administration & dosage*; D002547:Cerebral Palsy / Q000503:physiopathology*; D002648:Child; D002675:Child, Preschool; D004863:Equinus Deformity / Q000188:drug therapy* / Q000503:physiopathology*; D005260:Female; D005528:Foot; D020233:Gait Disorders, Neurologic / Q000188:drug therapy* / Q000503:physiopathology*; D006801:Humans; D008297:Male; D009465:Neuromuscular Agents / Q000008:administration & dosage*; D010865:Pilot Projects; D011312:Pressure; D012815:Signal Processing, Computer-Assisted
D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A