Document Detail


Outcomes of lower extremity orthopedic surgery in ambulatory children with cerebral palsy with and without gait analysis: Results of a randomized controlled trial.
MedLine Citation:
PMID:  23219787     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
This study examined the impact of gait analysis on surgical outcomes in ambulatory children with cerebral palsy (CP) through a randomized controlled trial. 156 children with CP (94 male; age 10.2±3.7 years) underwent gait analysis and were randomized to two groups: Gait Report group (N=83), where the referring surgeon received the patient's gait analysis report, and Control group (N=73), where the surgeon did not receive the gait report. Outcomes were assessed pre- and 1.3±0.5 years post-operatively. An intent-to-treat analysis compared outcomes between the two groups. Outcome measures included the Gillette Functional Activity Questionnaire (FAQ), Gait Deviation Index (GDI), oxygen cost, gross motor function measure, Child Health Questionnaire (CHQ), Pediatric Outcomes Data Collection Instrument (PODCI), and Pediatric Evaluation and Disability Inventory. The outcomes that differed significantly between groups were change in health from the CHQ, which was rated as much better for 56% (46/82) of children in the Gait Report group compared with 38% (28/73) in the Control group (p=0.04), and upper extremity physical function from the PODCI. Gait outcomes (FAQ and GDI) improved more when over half of the recommendations for a patient were followed or the recommended extent of surgery (none, single, or multi-level) was done (p≤0.04). On average, however, only 42% of the recommendations were followed in the Gait Report group, compared with 35% in the Control group (p=0.23). This is much less than the >85% reported in previous studies and may account for the lack of differences between groups for some of the outcome measures.
Authors:
Tishya A L Wren; Norman Y Otsuka; Richard E Bowen; Anthony A Scaduto; Linda S Chan; Sandra W Dennis; Susan A Rethlefsen; Bitte S Healy; Reiko Hara; Minya Sheng; Robert M Kay
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-12-6
Journal Detail:
Title:  Gait & posture     Volume:  -     ISSN:  1879-2219     ISO Abbreviation:  Gait Posture     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2012-12-10     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9416830     Medline TA:  Gait Posture     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012. Published by Elsevier B.V.
Affiliation:
Children's Orthopaedic Center, Children's Hospital Los Angeles, Los Angeles, CA, United States; Department of Orthopaedic Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States. Electronic address: twren@chla.usc.edu.
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