Upper extremity kinetics of children with myelomeningocele during Lofstrand crutch-assisted gait.
The use of quantitative methods for evaluating upper extremity (UE) dynamics in children with myelomeningocele (MM) is currently limited. We present a novel biomechanical model for assessment of UE dynamics during Lofstrand (forearm) crutch-assisted gait with application in 9 children with MM. Two prominent types of forearm, crutch-assisted gait patterns were studied: 1) reciprocal gait (RG) and 2) swing-through gait (STG). The model demonstrated the ability to successfully detect meaningful differences in wrist, elbow, shoulder and crutch dynamics in the population of 9 children tested. Significant differences in kinetics with reciprocal and swing-through gait patterns were found bilaterally at all joints. Notable differences were found in the mean superior/inferior joint forces, ranges of joint force, and maximum inferior joint forces. Accurate quantitative assessment may help to prevent injury from longer-term crutch use and has the potential for improving clinical intervention and therapeutic management of ambulation in children with MM.
Slavens
Brooke A
BA
Orthopaedic and Rehabilitation Engineering Center, O.R.E.C., Milwaukee, WI, USA.
Sturm
Peter F
PF
Harris
Gerald F
GF
D001696:Biomechanical Phenomena; D002648:Child; D003446:Crutches; D003936:Diagnosis, Computer-Assisted / Q000379:methods*; D019544:Equipment Failure Analysis / Q000379:methods; D020233:Gait Disorders, Neurologic / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology* / Q000534:rehabilitation*; D006801:Humans; D007700:Kinetics; D008591:Meningomyelocele / Q000503:physiopathology; D009119:Muscle Contraction; D018482:Muscle, Skeletal / Q000503:physiopathology*; D015203:Reproducibility of Results; D013119:Spinal Cord Injuries / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology / Q000534:rehabilitation; D013314:Stress, Mechanical; D034941:Upper Extremity / Q000503:physiopathology*