After treatment, based on SPM analysis, we noted a significantly improved knee extension during stance, an earlier peak knee flexion during swing, and an increased ankle dorsiflexion throughout most of the gait cycle. Springer-Verlag New York, Thorofare, NJ, Slack, Overall, there is no consensus on which features should be evaluated after BTX-A treatment as 49 features were reported only once or twice. Received Jan 8; Accepted Mar
Part 1—53 kinematic and 33 kinetic features were described in literature. The effects were mainly observed at the ankle joint and to a lesser extent at the knee. However, the post-3DGA evaluation in this study was on average one year and ten months post-BTX-A injections, making it unlikely to detect a therapeutic effect from the treatment. Key words included cerebral palsy, diplegia, hemiplegia, quadriplegia, gait analysis, locomotion, walking, gait, feature, parameter, variable, and characteristic. Conclusion In conclusion, both the outcome of the current study as well as literature reports conclude that BTX-A injections are a valuable treatment option to improve gait in children with CP. In these two studies, as well as in our experimental study, all children received injections to the gastrocnemius along with a period of stretching casts to the lower legs. On the other hand, the maximal dorsiflexion angle during stance was reported in 23 papers and 21 of them found an improved maximal dorsiflexion angle post-BTX-A[ 5 ], [ 6 ], [ 9 ], [ 18 ], [ 26 ], [ 27 ], [ 29 — 31 ], [ 34 — 44 ], [ 47 ].
Sample Essay English
The aim of this literature review sample spm was twofold. This article has been cited by other articles in Literature review sample spm. In the same line, few papers in literature report a significant change of pelvic and hip kinematics post-BTX-A treatment. Conceived and designed the experiments: In case the definition of a feature in literature was unclear and we were unable to recalculate it for our own data, it was excluded from the analysis.
The SPM paired Hotellings T 2 statistic takes into account the time dependency of all points of the gait cycle, as well as the covariance of joint kinematics over the three anatomical planes [ 25 ]. Pelvis across anatomical planes: All kinematic and kinetic features of the papers identified during the review, were extracted. S8 Table Kinetic ankle features extracted from 26 papers, identified through systematic literature search.
Spm English Essay
Literature review sample spm case multiple gait analysis sessions were available for one patient, a preference was given to the gait analyses that were collected before and after the first or second BTX-A treatment because patients are likely to improve more after literature review sample spm first treatments [ 19 ]. Key words included cerebral palsy, diplegia, hemiplegia, quadriplegia, gait analysis, locomotion, walking, gait, feature, parameter, variable, and characteristic.
In our intervention study, thirteen patients who had received a third BTX-A treatment and one who had received a fourth treatment were included, which could have led to a reduced effect of BTX-A compared to earlier studies. After treatment, based on SPM analysis, we noted a significantly improved knee extension during stance, an earlier peak knee flexion during swing, and an increased ankle dorsiflexion throughout most of the gait cycle.
The key issue which we discussed in this study was the statistical analysis used to analyze 3DGA data. On the other hand, the maximal dorsiflexion angle during stance was reported in literature review sample spm papers and 21 of them found an improved maximal dorsiflexion angle post-BTX-A[ 5 ], [ 6 ], [ 9 ], [ 18 ], [ 26 ], [ 27 ], [ 29 — 31 ], [ 34 — 44 ], [ 47 literature review sample spm. Apart from different statistical approaches and whether or not literature review sample spm Type I error is controlled, another factor that could account for differences in results among the included papers could be the small sample sizes.
Apart from the initial literature search, two reviewers completed each step of the review process and a third reviewer was consulted in case of disagreement.
A total of 53 patients were included in this study. Discussion In this study, we tested the hypothesis that lower limb joint kinematics of children with a spastic diagnosis of CP would improve toward a more typical gait pattern post-BTX-A. Often iliopsoas, adductors, rectus femoris, soleus, and tibialis posterior were also included in the multilevel BTX-A treatment, though less frequently Table 2.
Received Jan 8; Accepted Mar The SPM and feature analyses of the experimental outcome study did not highlight significant effects of BTX-A treatment on the pelvic and hip literature review sample spm in the three anatomical planes. Through a literature review, the available expert knowledge on gait changes after BTX-A treatment in children with CP is summarized. Additionally, it also literature review sample spm into account the dependency between different time instances of the gait cycle [ 11 ], [ 12 ].
However, different statistical approaches may lead to different interpretations of treatment outcome. On the one hand, we analyzed kinematic gait features that have previously been reported in literature and on the other hand we conducted SPM analyses. Furthermore, by conducting statistical testing on multiple dependent gait features in relatively small sample sizes, the risk of detecting a false positive outcome type I error increases. It is not clear whether this feature refers to a specific time instance literature review sample spm the gait cycle, or whether it refers to the mean value or peak value literature review sample spm the hip during a phase of gait.
Our study compared this frequently reported feature analysis to SPM. However a detailed analysis of all these factors would require a thorough evaluation of the methodological quality of the papers, which was beyond the scope of the current study. The currently presented literature review could be a guide for feature selection. For literature review sample spm with bilateral CP, both legs were eligible for analysis and for children with unilateral CP, only the affected leg was included. The study of Bottos et al.
The top graph shows the mean kinematics of the knee in the sagittal plane of 73 included legs pre-BTX-A treatment light grey versus post-BTX-A treatment dark gray. Because the motion of one joint is also co-varying dependent with the motion at other joints, we applied a Bonferroni correction literature review sample spm the five SPM analyses to obtain a more appropriate alpha level.
Non-directed hypotheses evaluated with SPM analysis may help to reduce the wealth of 3DGA data and aid the construction of more specific, directed hypotheses in the future.
After a thorough quality check of all literature review sample spm gait trials, the kinematic parameters reported in literature as well as waveform literature review sample spm were exported using custom-made Matlab software Mathworks, Inc. In the literature however, several intervention studies that have examined the effect of treatment on gait, have reduced the amount of 3DGA data a priori by analyzing a number of specific kinematic or kinetic gait features, which refer to a specific time instant of a gait cycle, e.
The muscles selected for treatment were injected at multiple sites with a maximum of 50U per site and a minimal distance of 5 literature review sample spm between injection sites.
S6 Table Kinetic hip features extracted from 26 papers, identified through systematic literature search. Additionally, an improvement in knee extension could also be expected after BTX-A injections to the gastrocnemius.
Pathological gait is one of the most striking characteristics in children with cerebral palsy CP [ 1 ].