Angela Nieuwenhuys1, Sylvia Õunpuu2, Anja Van Campenhout3,4, Tim Theologis5, Josse De Cat1,6, Jean Stout7, Guy Molenaers3,4, Tinne De Laet8, Kaat Desloovere1,6. 1. Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium. 2. Center for Motion Analysis, Division of Orthopaedics, Connecticut Children's Medical Center, Farmington, CT, USA. 3. Department of Development and Regeneration, KU Leuven, Leuven, Belgium. 4. Department of Orthopedics, University Hospitals Leuven, Leuven, Belgium. 5. Nuffield Orthopaedic Centre, Oxford University Hospitals NHS Trust, Oxford, UK. 6. Clinical Motion Analysis Laboratory, University Hospitals Leuven, Leuven, Belgium. 7. Gillette Children's Specialty Healthcare, St. Paul, MN, USA. 8. Faculty of Engineering Science, KU Leuven, Leuven, Belgium.
Abstract
AIM: This study aims to achieve an international expert consensus on joint patterns during gait for children with cerebral palsy (CP) by means of Delphi surveys. METHOD: In Stage 1, seven local experts drafted a preliminary proposal of kinematic patterns for each lower limb joint in the sagittal, coronal, and transverse plane. In Stage 2, 13 experts from eight gait laboratories (four in the USA and four in Europe), participated in a Delphi consensus study. Consensus was defined by a pre-set cut-off point of 75% agreement among participants. RESULTS: After the first stage, 44 joint patterns were presented in a first survey and 29 patterns reached consensus. Consensus improved to 47 out of 48 patterns in the third survey. Only one pattern, 'abnormal knee pattern during loading response', did not reach consensus. The expert panel agreed to define six patterns for the knee during swing, most of them representing characteristics of a stiff knee pattern. INTERPRETATION: The defined joint patterns can support clinical reasoning for children with CP as joint patterns during gait might be linked to different treatment approaches. Automating the classification process and incorporating additional trunk, foot, and electromyography features should be prioritized for the near future.
AIM: This study aims to achieve an international expert consensus on joint patterns during gait for children with cerebral palsy (CP) by means of Delphi surveys. METHOD: In Stage 1, seven local experts drafted a preliminary proposal of kinematic patterns for each lower limb joint in the sagittal, coronal, and transverse plane. In Stage 2, 13 experts from eight gait laboratories (four in the USA and four in Europe), participated in a Delphi consensus study. Consensus was defined by a pre-set cut-off point of 75% agreement among participants. RESULTS: After the first stage, 44 joint patterns were presented in a first survey and 29 patterns reached consensus. Consensus improved to 47 out of 48 patterns in the third survey. Only one pattern, 'abnormal knee pattern during loading response', did not reach consensus. The expert panel agreed to define six patterns for the knee during swing, most of them representing characteristics of a stiff knee pattern. INTERPRETATION: The defined joint patterns can support clinical reasoning for children with CP as joint patterns during gait might be linked to different treatment approaches. Automating the classification process and incorporating additional trunk, foot, and electromyography features should be prioritized for the near future.
Authors: Anne M Comi; Mustafa Sahin; Adrienne Hammill; Emma H Kaplan; Csaba Juhász; Paula North; Karen L Ball; Alex V Levin; Bernard Cohen; Jill Morris; Warren Lo; E Steve Roach Journal: Pediatr Neurol Date: 2016-03-16 Impact factor: 3.372
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