The reliability of three-dimensional kinematic gait measurements: a systematic review.

Quantification of human motion: gait analysis—benefits and limitations to its application to clinical problems

Although fasciae have long interested clinicians in a multitude of different clinical and paramedical disciplines, there have been few attempts to unite the ensuing diverse literature into a single review. The current article gives an anatomical perspective that extends from the gross to the molecular level. For expediency, it deals only with fascia in the limbs and back. Particular focus is directed towards deep fascia and thus consideration is given to structures such as the fascia lata, thoracolumbar fascia, plantar and palmar fascia, along with regional specializations of deep fascia such as retinacula and fibrous pulleys. However, equal emphasis is placed on general aspects of fascial structure and function, including its innervation and cellular composition. Among the many functions of fascia considered in detail are its ectoskeletal role (as a soft tissue skeleton for muscle attachments), its importance for creating osteofascial compartments for muscles, encouraging venous return in the lower limb, dissipating stress concentration at entheses and acting as a protective sheet for underlying structures. Emphasis is placed on recognizing the continuity of fascia between regions and appreciating its key role in coordinating muscular activity and acting as a body-wide proprioceptive organ. Such considerations far outweigh the significance of viewing fascia in a regional context alone.

https://onlinelibrary.wiley.com/doi/pdf/10.1111/j.1469-7580.2008.01011.x

The fascia of the limbs and back--a review

Quantitative comparison of five current protocols in gait analysis

Reliability and minimal detectible change values for gait kinematics and kinetics in healthy adults

We treated 22 children (28 limbs) with diplegic cerebral palsy who were able to walk by the Baumann procedure for correction of fixed contracture of the gastrosoleus as part of multilevel single-stage surgery to improve gait. The function of the ankle was assessed by clinical examination and gait analysis before and at two years (2.1 to 4.0) after operation. At follow-up the ankle showed an increase in dorsiflexion at initial contact, in single stance and in the swing phase. There was an increase in dorsiflexion at initial push-off without a decrease in the range of movement of the ankle, and a significant improvement in the maximum flexor moment in the ankle in the second half of single stance. There was also a change from abnormal generation of energy in mid-stance to the normal pattern of energy absorption. Positive work during push-off was significantly increased. Lengthening of the gastrocnemius fascia by the Baumann procedure improved the function of the ankle significantly, and did not result in weakening of the triceps surae. We discuss the anatomical and mechanical merits of the procedure.

The Baumann procedure for fixed contracture of the gastrosoleus in cerebral palsy. Evaluation of function of the ankle after multilevel surgery.

The Baumann procedure for fixed contracture of the gastrosoleus in cerebral palsy

Multilevel surgery for gait improvement was performed on 29 ambulatory children with diplegic cerebral palsy. Patients were divided into two groups based on the presence of dynamic equinus (12 cases) and fixed equinus deformity (17 cases). Dynamic equinus deformities were not corrected surgically, and fixed deformities were corrected by intramuscular gastrosoleus lengthening. Ankle function was evaluated by clinical examination and gait analysis before surgery and a minimum of 3 years after surgery. Positive changes in ankle function were observed in both the groups. Conservative management of dynamic equinus deformities resulted in significant improvements in ankle function. Intramuscular lengthening of fixed equinus deformities does not cause a weakening of the muscle and improves static and dynamic function of the ankle.

Fixed and dynamic equinus in cerebral palsy: evaluation of ankle function after multilevel surgery.

Les auteurs ont realise une etude de la marche chez 16 enfants IMC qui presentaient une demarche de type diplegique ou en rotation interne de type spastique, avant et en moyenne 3 ans apres chirurgie sur les tissus mous Ils ont observe une correction significative de la demarche en rotation interne apres une operation comportant plusieurs gestes sur les tissus mous, avec allongement des ischio-jambiers internes dans tous les cas Ces resultats suggerent qu'en l'absence de trouble rotationnel fixe par des deformations osseuses, une intervention a plusieurs niveaux sur les tissus mous peut effectivement corriger la demarche en rotation interne chez des enfants IMC presentant cette anomalie

Assessment of hip rotation after gait improvement surgery in cerebral palsy

Two cases of deformities in scarred feet are presented. One case had an old, well healed forefoot amputation with severe equinovarus deformity, and the other had an equinus deformity following a burn injury 10 months prior. Both the cases were managed by primary release of the contracted joint capsules. The correction of the soft-tissue contractures was achieved by gradual distraction using the llizarov apparatus. The clinical presentation and surgical treatment of complex foot deformities, complicated by the presence of scar tissue, are presented. These cases illustrate the benefits of combining soft-tissue release with the llizarov technique of distraction histogenesis in the treatment of complicated foot deformities associated with scarring in pediatric patients.

Complex foot deformities associated with soft-tissue scarring in children.

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