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Gait analysis for individually tailored interdisciplinary interventions in children with cerebral palsy: a randomized controlled trial
Author(s) -
Rasmussen Helle M,
Pedersen Niels W,
Overgaard Søren,
Hansen Lars K,
DunkhaseHeinl Ulrike,
Petkov Yanko,
Engell Vilhelm,
HolsgaardLarsen Anders
Publication year - 2019
Publication title -
developmental medicine and child neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.658
H-Index - 143
eISSN - 1469-8749
pISSN - 0012-1622
DOI - 10.1111/dmcn.14178
Subject(s) - cerebral palsy , gait , psychological intervention , physical therapy , medicine , gross motor function classification system , randomized controlled trial , physical medicine and rehabilitation , gait analysis , quality of life (healthcare) , spasticity , surgery , nursing , psychiatry
Aim To test the hypothesis that improvements in gait and function following individualized interdisciplinary interventions consisting of physical therapy, orthotics, spasticity management, and orthopaedic surgery using instrumented gait analysis are superior to ‘usual care’ in children with cerebral palsy ( CP ). Method This was a prospective, single‐blind, parallel‐group, randomized controlled trial investigating the effectiveness of interventions based on the use of gait analysis. Primary outcome was gait (Gait Deviation Index) and secondary outcomes were walking and patient‐reported outcome measures of function, disability, and health‐related quality of life. Follow‐ups were done at 26 weeks (questionnaires) and at the primary end point of 52 weeks (all outcomes). Results Sixty participants with CP (39 males, 21 females, mean age 6y 10mo, standard deviation 1y 3mo, range 5y–9y 1mo) in Gross Motor Function Classification System levels I or II , were randomized to interventions with or without gait analysis. No significant or clinically relevant between‐group differences in change scores of the primary or secondary outcomes were found. The recommended categories of interventions were dominated by non‐surgical interventions and were applied in 36% to 86% of the participants. Interpretation Interventions using gait analysis were not superior to ‘usual care’ on gait, walking, or patient‐reported outcomes in a sample of relatively young and independently walking children with CP not expected to need surgery. What this paper adds Gait analysis in children with cerebral palsy in Gross Motor Function Classification System levels I or II recommends interdisciplinary interventions. Compliance to interventions recommended after gait analysis was low. No statistically significant advantages were identified for the intervention group versus the control group.