Transcript

ESMAC 2012 abstract / Gait & Posture 38 (2013) S1–S116 S19

technique it seems necessary to continue to run the different tech-niques systematically and concurrently. The between assessorsagreement measures of the ranking and agreement score, 0.23 and0.51 respectively, displayed only fair agreement. Further researchis required to develop a more objective measurement of the kneeaxis accuracy.

References

[1] Schwartz MH, Rozumalski A. A new method for estimating joint parameters frommotion data. JB 2005;38:107–16.

[2] Sangeux M, Baker R. Reliability of hip and knee curves in gait analysis. JEGM2010. Miami.

http://dx.doi.org/10.1016/j.gaitpost.2013.07.043

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A tablet computer “app” forneuromusculoskeletal physical examination inchildren with cerebral palsy

Kim Van Hutten, Jaap Harlaar, Lia Out, MerelBrehm

VU University Medical Center, Department ofRehabilitation Medicine, Amsterdam, TheNetherlands

Introduction: Physical examination of neuromusculoskele-tal and movement-related functions is commonly performed inchildren with cerebral palsy (CP). Next to instrumented gait anal-ysis, neuromusculoskeletal physical examination (NMS-PE) is anessential element in clinical decision-making, especially whenorthopaedic or neurosurgery is indicated. Taking a complete NMS-PE is rather extensive, so the examination and its registration cantake quite some time. Accordingly, not all NMS-PE items are alwaysperformed, leading to incompleteness of data. Also paper basedforms are subjected to data entry mistakes, and might even getlost. Altogether, this may result in suboptimal decision-making. Thequality of NMS- PE will be improved by technology that supportstaking a PE. The aim of this project was to develop an innovative,easy to use tool (an “app”) for data entry and data storage of NMS-PEfindings in children with CP.

Patients/materials and methods: The content of the NMS-PEtool is based on a recently published guideline book [1]. Require-ments and a functional design of the app were drafted in closecooperation with health-care professionals. Based on these require-ments, a user interface was developed, as well as a database to storethe entered data. A prototype of the NMS-PE app was tested in apilot study. During the pilot study, NMS-PEs were performed inchildren with CP whom were seen for a first appointment at theoutpatient clinic of a university hospital. Examinations were per-formed with the old method (manual data entry on paper sheets)and with the new method (digital data entry) on a second cohort.Factors of success and failure were documented during the pilot.Furthermore, efficiency (time to perform the examination), com-pleteness of data registration (% completed items) and satisfactionwere evaluated.

RESULTS

Discussion & conclusions: Positive reactions on feasibility ofworking with the newly developed physical examination tool, com-bined with increased standardization, efficiency and completenessof data show that a digital method of data entry and data storagecan be extremely useful in clinical practice. As such, it can add tothe quality of the physical examination in children with CP, whichis especially important for children who are indicated for complexoperations.

Reference

[1] Becher et.al. Reed Business 2012; Amsterdam, The Netherlands.

http://dx.doi.org/10.1016/j.gaitpost.2013.07.044

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The impact of ankle-foot orthoses one year postorthopaedic surgery in children with cerebralpalsy

Ingrid Skaaret 1, Merete Aa Fosdahl 1, BjornLofterod 1, Inger Holm 1,2

1 Oslo University Hospital, Oslo, Norway2 University of Oslo, Oslo, Norway

Introduction: Lower limb orthopaedic surgery is often neces-sary in order to facilitate and prolong efficient gait in childrenwith cerebral palsy. In the postoperative period ankle foot orthoses(AFO) are used to preserve the effect of the surgery. Such orthosesare made with different designs, typically constructed according toguidelines specified by the pre-operative gait analysis and overalltreatment plan. The contribution of AFO’s to influence gait func-tion after surgery has only been investigated to a small degree.The aim of the present study was to evaluate the impact of AFO’son selected gait variables at the time of routine three-dimensionalgait analysis (3DGA) ≥1 year post lower limb surgery in childrenwith bilateral spastic cerebral palsy (BSCP) using the Gait ProfileScore (GPS) and Movement Analysis Profile (MAP) [1] to quantifykinematic outcome.