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dc.contributor.author
Visscher, Rosa
dc.contributor.author
Hasler, Nadine
dc.contributor.author
Freslier, Marie
dc.contributor.author
Singh, Navrag B.
dc.contributor.author
Taylor, William R.
dc.contributor.author
Brunner, Reinald
dc.contributor.author
Rutz, Erich
dc.date.accessioned
2021-03-12T13:28:52Z
dc.date.available
2021-03-12T08:50:17Z
dc.date.available
2021-03-12T13:28:52Z
dc.date.issued
2021
dc.identifier.issn
0936-8051
dc.identifier.issn
0344-8444
dc.identifier.issn
1434-3916
dc.identifier.other
10.1007/s00402-021-03797-0
en_US
dc.identifier.uri
http://hdl.handle.net/20.500.11850/474123
dc.description.abstract
Introduction Single-event multilevel surgery (SEMLS) is frequently used to correct pathological gait patterns in children with bilateral spastic cerebral palsy (BSCP) in a single session surgery. However, in-depth long-term evaluation reports of gait outcomes are limited. Therefore, we investigated if SEMLS is able to correct lower extremity joint and pelvic angles during gait towards typically developing gait patterns (TDC) in children with BSCP, and if so, if this effect is durable over a 10-year period. Materials and methods In total 13 children with BSCP GMFCS level II at time of index-surgery between the ages of 7.7–18.2 years at the time of SEMLS were retrospectively recruited. Three-dimensional gait data were captured preoperatively, as well as at short-, mid-, and long-term post-operatively, and used to analyze: movement analysis profile (MAP), gait profile score (GPS), and lower extremity joint and pelvic angles over the course of a gait cycle using statistical parametric mapping. Results In agreement with previous studies, MAP and GPS improved towards TDCs after surgery, as did knee extension during the stance phase (ɳ2 = 0.67; p < 0.001), while knee flexion in the swing phase (ɳ2 = 0.67; p < 0.001) and pelvic tilt over the complete gait cycle (ɳ2 = 0.36; p < 0.001) deteriorated; no differences were observed between follow-ups. However, further surgical interventions were required in 8 out of 13 of the participants to maintain improvements 10 years post-surgery. Conclusions While the overall gait pattern improved, our results showed specific aspects of the gait cycle actually deteriorated post-SEMLS and that a majority of the participants needed additional surgery, supporting previous statements for the use of multilevel surgery rather than SEMLS. The results highlight that the field should not only focus on the overall gait scores when evaluating treatment outcomes but should offer additional long-term follow-up of lower extremity function.
en_US
dc.language.iso
en
en_US
dc.publisher
Springer
en_US
dc.subject
Cerebral palsy
en_US
dc.subject
Multilevel surgery
en_US
dc.subject
Statistical parametric mapping
en_US
dc.subject
Long-term outcomes
en_US
dc.subject
Clinical gait analysis
en_US
dc.subject
Longitudinal care
en_US
dc.title
Long-term follow-up after multilevel surgery in cerebral palsy
en_US
dc.type
Journal Article
dc.date.published
2021-02-23
ethz.journal.title
Archives of Orthopaedic and Trauma Surgery
ethz.journal.abbreviated
Arch Orthop Trauma Surg
ethz.size
8 p.
en_US
ethz.identifier.wos
ethz.publication.place
Berlin; Heidelberg
en_US
ethz.publication.status
published
en_US
ethz.leitzahl
ETH Zürich::00002 - ETH Zürich::00012 - Lehre und Forschung::00007 - Departemente::02070 - Dep. Gesundheitswiss. und Technologie / Dep. of Health Sciences and Technology::02518 - Institut für Biomechanik / Institute for Biomechanics::03994 - Taylor, William R. / Taylor, William R.
en_US
ethz.leitzahl.certified
ETH Zürich::00002 - ETH Zürich::00012 - Lehre und Forschung::00007 - Departemente::02070 - Dep. Gesundheitswiss. und Technologie / Dep. of Health Sciences and Technology::02518 - Institut für Biomechanik / Institute for Biomechanics::03994 - Taylor, William R. / Taylor, William R.
en_US
ethz.date.deposited
2021-03-12T08:50:27Z
ethz.source
FORM
ethz.eth
yes
en_US
ethz.availability
Metadata only
en_US
ethz.rosetta.exportRequired
true
ethz.COinS
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