Gait & posture最新文献

{"title":"Subtalar joint axis alignments in pathological feet of children with cerebral palsy","authors":"Erik Meilak, Ruud Wellenberg, Wouter Schallig, Andrew Roberts, Melinda Witbreuk, Annemieke Buizer, Mario Maas, Marjolein van der Krogt, Luca Modenese, Caroline Stewart","doi":"10.1016/j.gaitpost.2023.07.152","DOIUrl":"https://doi.org/10.1016/j.gaitpost.2023.07.152","url":null,"abstract":"Children suffering cerebral palsy (CP) often develop foot deformities [1]. These manifest as pathological postures including equinovarus, planovalgus non-midfoot break (PNMFB) and midfoot break (MFB) [2]. Although the mechanism for the development of foot deformity is poorly understood, recent research has highlighted how sensitive muscle moment arms [3] and joint moments are to the orientation of the subtalar joint (STJ) axis. Both are contributors to foot deformity. Studies have demonstrated a large variability in STJ axis orientations in healthy populations [4] and it is hypothesised that the variability in deformed feet will be even higher and correlate with specific deformities. How do STJ axis orientations in CP children with equinovarus, PNMFB and MFB deformities compare with typically developing children? Weight bearing (WB) and non-weight bearing (NWB) cone beam CT images of 21 feet from 17 CP patients (8 equinovarus, 7 PNMFB, 6 MFB, aged 12-17) and 7 feet from 7 typically-developing controls (aged 7-16) were acquired using a Verity (Planmed Oy) and Multitom Rax (Siemens) CBCT systems. Foot bones were semi-automatically segmented using Mimics 24.0, Materialize or Disior Bonelogic and remeshed to 1.0 mm isotropic edge length (OpenFlipper 4.1). Using the STAPLE pipeline [5], spheres were fitted to the talar head and talocalcaneal articulating surfaces and a cylinder to the talocrural articulating surface. STJ axis was approximated by the line joining the two fitted spheres [6]. The talocrural joint axis was approximated by the cylinder fitted to the talocrural articulating surface. An anterior-posterior (AP) line was calculated as the cross product of the ground normal and the talocrural joint axis. For each participant, STJ axis medial deviation and inclination from the AP line was calculated. A 2-sample t-test was used to test for statistically significant differences between groups. Mean STJ axis orientation in healthy participants was 23.2±5.7° (inclination) and 22.0±4.3° (medial deviation, Fig. 1). Inclinations varied from 31.4±6.3° for equinovarus feet to 20.2±4.2 for PNMFB and 4.0±10.6° for MFB patients. Mean medial deviations were 32.7±10.5° (equinovarus), 25.4±6.5° (PNMFB), and 28.8±4.5° (MFB). Both MFB and equinovarus groups exhibited STJ axis medial deviation angles greater than healthy controls. However, where the equinovarus group demonstrated 8.2° (p<0.05) greater inclination angle than the healthy controls, the MFB feet exhibited inclination angles 19.2° lower (p<0.05).Download : Download high-res image (99KB)Download : Download full-size image Although the analysis shows clear groupings in STJ axis orientations, further analyses of a greater range of CP pathological feet are needed to confirm these differences between groups. The abnormal STJ axis orientations of the deformed feet imply that abnormal moments are present during gait, further contributing to deformity. In conclusion, there is a measurable difference between t","PeriodicalId":94018,"journal":{"name":"Gait & posture","volume":"27 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135297890","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medial gastrocnemius muscle morphology in spastic cerebral palsy: A comparison between treatment naïve children and children with a treatment history","authors":"Fenna Walhain, Britta Hanssen, Rhea Spong-Cruden, Delaja Plein, Chelsi Bardan, Ruby Chin A Fat, Marlies Declerck, Lynn Bar-On, Anja Van Campenhout, Kaat Desloovere","doi":"10.1016/j.gaitpost.2023.07.261","DOIUrl":"https://doi.org/10.1016/j.gaitpost.2023.07.261","url":null,"abstract":"In children with spastic cerebral palsy (SCP), conservative interventions such as physiotherapy, intra-muscular Botulinum Neurotoxin-A (BoNT-A) and serial casting are applied to counteract neuromuscular impairments [1]. The accumulated effects of these treatments on alterations in macroscopic muscle morphology are difficult to evaluate [2]. In Suriname, the access to these treatments for SCP-children is limited. Studying a cohort of treatment-naïve children, in comparison to a group of children with treatment history, can gain insight in the natural course of altered muscle morphology. Are the medial gastrocnemius (MG) macroscopic muscle morphology alterations different between treatment-naïve SCP children and SCP children with treatment history? In this cross-country comparison study, 20 treatment-naïve children from Suriname were case-control matched by age, GMFCS level and topographical description with 20 SCP-children with treatment history from Belgium. In addition, the data from 20 age-matched typically developing (TD) children from Belgium and 20 age-matched TD children from Suriname were assessed for comparison. A child was treatment-naïve if there was no previous 1) lower limb surgery, 2) serial casting in the last 3 years, 3) lower limb Botulinum Neurotoxin type A (BoNT-A) injection, 4) orthoses and 5) more than 10 physiotherapy sessions a year. SCP children had treatment history if they received usual care including orthoses and regular physiotherapy, and had access to BoNT-A treatment if clinically needed. Children with treatment history were excluded if they had 1) soft-tissue surgery, 2) BoNT-A injection in the last 10 months, 3) lower limb bony surgery in the last 2 years, 4) neurosurgery or 5) baclofen pump. Muscle-tendon unit (MTU) length, muscle length, tendon length and muscle volume were acquired from the MG with 3D freehand ultrasound measurement, which has proven reliability and validity [3]. Similar equipment, acquisition and processing procedures were used in both countries. The morphological alterations of the SCP child were calculated as a percentage of the morphology of the locally matched TD child. The medians and interquartile ranges of the deviation in morphology were defined, and treatment-naïve SCP-children and children with treatment history were compared by a Mann-Whitney U test. Both, the treatment-naïve and treatment-history groups showed alterations in their MG-muscle morphology compared to TD with greatest deviations in muscle volume (-47(19)% versus -31(30)%, Table 1). However, there were no significant differences in alterations for muscle volume, muscle length, tendon length and MTU length between treatment-naïve children and children with treatment history.Download : Download high-res image (167KB)Download : Download full-size image The natural course of pathological muscle morphology in treatment-naïve SCP-children seems comparable to SCP-children with treatment history. This may imply that the effect of","PeriodicalId":94018,"journal":{"name":"Gait & posture","volume":"57 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135298026","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Can we predict lower extremity motor control problems from single leg standing test for children with cerebral palsy?","authors":"Kubra Onerge, Mervenur Arslan, Nazif Ekin Akalan, Rukiye Sert, Halenur Evrendilek","doi":"10.1016/j.gaitpost.2023.07.179","DOIUrl":"https://doi.org/10.1016/j.gaitpost.2023.07.179","url":null,"abstract":"Selective voluntary motor control (SVMC) is a major contributor to motor function, balance, and gait performance in spastic cerebral palsy (SCP)(1). Single-leg standing (SLS) is a simple test to measure static balance which is highly correlated(2) and affected by impaired voluntary control in SCP(3). Therefore, a rapid and effective clinical evaluation of SVMC is of great importance. The aim of the study is to test whether SVMC assessment can be performed during SLS. May lower extremity SVMC be predicted during SLS in children with SCP? A total of 42 limbs of 11 children with SCP (6 females, 6 bilateral, 5 unilateral, 17 affected limbs; 11.33 ± 3.13 y.o, 39.14 ± 12.42 kg, 141.86 ± 14.46 cm) and 10 typically developed (TD) controls (4 females; 12.04 ± 3.16 y.o, 44.42 ± 16.12 kg, 151.88 ± 16.56 cm) were assessed in the study. The Selective Control Assessment of the Lower Extremity (SCALE) tool was used to measure SVMC(4). Hip, knee, and ankle movements were evaluated with a 3-point likert scale (2: normal, 1: impaired, 0: unable) at the monarthric level. In order to predict SVMC during SLS, the participants were videotaped while standing on a flat surface on one limb for as long as they could without any support by a smartphone (Xiaomi Redmi 10,50 MP) with a tripod placed at knee-level height (anterolaterally 45°). The longest SLS (max 10 sec.) of the three separate video recordings was evaluated. Similar to the SCALE, a 0-1-2 scoring system was developed to assess each joint’s SVMC during SLS: (2: the expected movements to maintain balance, 1: partial movements to maintain stability, 0: no compensated movement). 4 pediatric physical therapists with 7+ years of experience scored the videos 2 times in total, 1 week apart. The intra-rater and inter-rater reliability were statistically analyzed with intraclass correlation coefficients (ICC) and corresponding 95% confidence intervals (CI)(p<0.05)(5). Intra-rater reliability ICC correlation was excellent level at the subtalar-joint, good level at the ankle and toes, moderate level at the knee, and poor level at the hip were found between SVMC and SLS (Table-1). Also, significantly good to excellent inter-rater reliability (from 0.619 to 0.911) was found between SLS and SVMC (p<0.001). Download : Download high-res image (195KB)Download : Download full-size image The video-based SLS novel assessment methodology in this study succeeded to have a good to excellent correlation on SVMC on foot (ankle-subtalar-toe) joint level which was moderately correlated with appropriate ankle dorsiflexion at late swing(6). Movement assessment during SLS may give so much information about the quality of SVMC at the ankle-foot level which is the most related item with the gait abnormality. The research team is currently continuing to increase the sample size by including more participants and train more raters with a simple form and/or videos.","PeriodicalId":94018,"journal":{"name":"Gait & posture","volume":"39 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135298195","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gender differences in distance between the talus and lateral malleolus during gait using ultrasound in healthy adults","authors":"Tsubasa Tashiro, Noriaki Maeda, Satoshi Onoue, Miki Kawai, Ayano Ishida, Shogo Tsutsumi, Satoshi Arima, Makoto Komiya, Yukio Urabe","doi":"10.1016/j.gaitpost.2023.07.242","DOIUrl":"https://doi.org/10.1016/j.gaitpost.2023.07.242","url":null,"abstract":"The anterior talofibular ligament connects the talus to the lateral malleolus and is an essential component in understanding the pathophysiology of ankle sprains. In recent years, ultrasound is often used in its evaluation, however, most of it remains a static assessment (Rein S et al., 2020). Are there gender differences in the dynamics of the distance between the talus and the lateral malleolus during the stance phase of gait using ultrasound in healthy adults? The participants in this study were 10 healthy males and 9 healthy females. All participants did not report a history of previous ankle sprains. We used a motion capture system (Vicon Motion Systems, UK) synchronized with an ultrasound (Art Us EXT-1H, Telemed, Vilnius, Lithuania) to examine the distance between the talus and the lateral malleolus during the stance phase of gait. The US probe (5-11 MHz, 60-mm field of view; Echoblaster, Telemed, Vilnius, Lithuania) was positioned on the lateral side of the ankle joint and visualized the most lateral part of the talus and lateral malleolus on the ultrasound screen. Participants walked at a comfortable speed on a force plate (OR-6, 1000 Hz: AMTI, USA) and the interval from heel contact to toe-off was included in the analysis. Tracker 5.1.5 software (Open-Source Physics) was used to calculate the distance between the talus and lateral malleolus and the amount of change with respect to that distance at heel contact. Unpaired t-tests were used to compare the gender differences in that distance in the early, middle, and terminal stance phases. The changes in the distance between the talus and the lateral malleolus were -0.15±1.15 mm in the early stance phase, -0.98±1.99 mm in the middle stance phase, and -0.77±1.99 mm in the terminal stance phase in males and -0.84±0.92 mm, -2.24±1.40 mm, and -0.64±1.52 mm in women, respectively. The changes in the distance were significantly higher in females than in males in the early and middle stance phases. In females, the distance between the talus and the lateral malleolus during the stance phase of gait is highly variable, and this hypermobility may be a risk for ankle sprains and future ankle osteoarthritis. Prior study has reported that joint laxity is greater in women than in men after puberty, which may affect the incidence of injury (Quatman CE et al., 2008). This study using ultrasound could provide a basic data for examining ankle dynamics during gait in patients with ankle sprains.","PeriodicalId":94018,"journal":{"name":"Gait & posture","volume":"96 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135298530","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ankle power support of spring-like ankle foot orthoses and their effect on compensatory joint work","authors":"Niels Waterval, Frans Nollet, Merel-Anne Brehm","doi":"10.1016/j.gaitpost.2023.07.265","DOIUrl":"https://doi.org/10.1016/j.gaitpost.2023.07.265","url":null,"abstract":"","PeriodicalId":94018,"journal":{"name":"Gait & posture","volume":"3 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135298549","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Movement patterns are different but muscle activations are unchanged in women with patellofemoral pain","authors":"Albuquerque Tadeu, Cintia Lopes Ferreira, Juliane Almeida, Barton Gabor, Paulo Lucareli","doi":"10.1016/j.gaitpost.2023.07.240","DOIUrl":"https://doi.org/10.1016/j.gaitpost.2023.07.240","url":null,"abstract":"Patellofemoral pain (PFP) is one of the leading causes of knee pain. Changes in movement patterns and a possible relationship between movement patterns and muscle activation are commonly found in women with PFP [1]. The Movement Deviation Profile (MDP) showed differences in the movement pattern in women with PFP [2], however, to the best of our knowledge, the MDP was not used to differentiate the electromyography of women with and without PFP. This study aimed to verify whether the combined analysis of kinematics and EMG data increases the ability to differentiate between women with and without PFP compared to the independent analysis of kinematics and electromyographic activity. Is there a difference in movement patterns and muscle activation between women with and without PFP? Could the combination of EMG with kinematics data increase the ability to differentiate women with and without PFP? Seventy-one women, 37 with PFP and 34 unimpaired were selected for kinematic and EMG evaluation during the Lateral Step Down (LSD) task. For the 3D kinematics, movements in the sagittal, frontal and transverse planes of the trunk, pelvis and hip were used; sagittal and frontal planes of the knee; ankle sagittal plane; and the transverse plane of the foot in relation to the laboratory. For the EMG, filtered, rectified and smoothed signals from the adductor longus, gluteus medius, vastus lateralis and medialis, rectus femoris, biceps femoris, medial gastrocnemius and tibialis anterior muscles were used, which were normalised in amplitude to the average of the peaks of each cycle of LSD and in time by resampling the EMG envelopes every 1% of the LSD cycle. The MDP, which is a single number measure of movement deviation derived from a multidimensional neural network analysis, was used to analyse kinematics, EMG and kinematics combined with EMG. The Z-score of the MDPmean was calculated to compare the standardised results between women with and without PFP. A multivariate analysis with Bonferroni post-hoc test compared the groups considering p < 0.05. Multivariate analysis showed group interaction (l=0.838; F=4.329; p=0.008). There was a significant difference between groups in the MDPmean Z-Score only for kinematics (0.97). There was no difference between groups for EMG (0.44) and kinematics with EMG (0.39).Download : Download high-res image (117KB)Download : Download full-size image This study corroborates with the literature demonstrating that women with PFP present changes in the movement pattern but not in the amplitude of the electromyography. EMG, even when evaluating with a self-organising neural network (MDP), considering several muscles relevant to PFP, failed to differentiate between women with and without PFP both on its own or combined with kinematics. We conclude that, when using MDP, kinematics is the variable capable of differentiating women with and without PFP during LSD.","PeriodicalId":94018,"journal":{"name":"Gait & posture","volume":"15 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135298551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of the degree of reliability in forensic gait analysis Methods","authors":"Alexia Patinioti, Georgios Gkrimas","doi":"10.1016/j.gaitpost.2023.08.026","DOIUrl":"https://doi.org/10.1016/j.gaitpost.2023.08.026","url":null,"abstract":"","PeriodicalId":94018,"journal":{"name":"Gait & posture","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135298553","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Kinematic limitations during obstacle-crossing in adolescent idiopathic scoliosis","authors":"Maria Rassam, Karim Hoyek, Rony El Hayeck, Georges Haddad, Emmanuelle Wakim, Elio Mekhael, Nabil Nassim, Ismat Ghanem, Rami El Rachkidi, Ayman Assi","doi":"10.1016/j.gaitpost.2023.07.203","DOIUrl":"https://doi.org/10.1016/j.gaitpost.2023.07.203","url":null,"abstract":"Scoliosis is a 3D spinal deformity that is known to affect patient’s alignment on static radiographs [1] and their movement during walking or other daily life activities [2]. Crossing obstacles is a common activity that can challenge patients’ stability. However, kinematics of the obstacle-crossing movement is still unknown in adolescent idiopathic scoliosis (AIS). Are kinematics affected in patients with AIS during obstacle-crossing? 18 AIS patients with major right convexity thoracic scoliosis (Cobb: 38° [25-55°]) and 15 controls (age and sex matched: 16 years, 85% F) underwent biplanar X-rays in standing position with the calculation of 3D radiographic spinopelvic parameters. 3D movement analysis was performed during obstacle-crossing, obstacle being fixed at 30% of lower limb length, and executed once with each leg leading the movement. Kinematic parameters of the head, trunk, pelvis, lower limbs and spinal segments were calculated [3,4]. Parameters were compared between the 2 groups and the relationship between kinematic and radiographic variables was investigated. During obstacle-crossing, AIS patients showed an increased thorax extension compared to controls (-19 vs 6°, p<0.05), especially in the main thoracic segment (T3T6-T6T9= 9 vs 14°, p<0.05). Conversely, AIS patients showed a decreased lumbar lordosis when compared to controls (T12L3-L3L5=-14 vs -20°, p<0.05). Moreover, AIS patients showed an anterior rotation (-2 vs 2°) and elevation (6 vs 0°, both p<0.05) of the right shoulder. Patients also showed a decreased hip abduction of the leading leg when compared to controls (-5 vs -9°, p<0.05). The main thoracic extension was correlated to the Cobb angle (r=-0.50) and the shoulder axial rotation to the apical vertebral rotation (r=0.75, both p<0.05; Fig. 1). AIS patients are known to have back flattening with a loss of lumbar lordosis due to their spinal deformity. This spinal malalignment was shown to persist dynamically during obstacle-crossing, associated with a forward shift and elevation of the convexity-side shoulder. The backward movement of the trunk and the shoulder rotation attitude, along with the decreased hip abduction, might hinder stability during obstacle-crossing. These kinematic alterations were shown to increase with the spinal deformity (increased Cobb and apical vertebral rotation). Future studies will investigate kinematic changes in AIS patients following spinal fusion. Fig. 1 Correlations between kinematic limitations and scoliosis severity in adolescent idiopathic scoliosis during obstacle-crossing movement.Download : Download high-res image (100KB)Download : Download full-size image","PeriodicalId":94018,"journal":{"name":"Gait & posture","volume":"57 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135298703","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of varus foot deformities on muscle moment arms in children with cerebral palsy","authors":"Gaia Van Den Heuvel, Wouter Schallig, Marjolein van der Krogt, Ruud Wellenberg, Mario Maas, Annemieke Buizer, Ajay Seth","doi":"10.1016/j.gaitpost.2023.07.256","DOIUrl":"https://doi.org/10.1016/j.gaitpost.2023.07.256","url":null,"abstract":"Children with cerebral palsy (CP) commonly develop deformities of the foot [1], which lead to pain and gait problems. One of the causes of such deformities is likely an imbalance in muscle forces around the foot [2]. In turn, these deformities can also alter muscle function due to altered muscle moment arms. Moment arms can be estimated using musculoskeletal models, but models based on generic bone geometry are unlikely to represent the deformity accurately. Weight-bearing computed tomography (WBCT) enables assessment of abnormal bone alignment under loaded conditions [3]. What are the changes in moment arm lengths of the main invertors and evertors (i.e. the tibialis and peroneal muscles) around the subtalar joint in children with cavovarus and equinovarus foot deformity due to CP? Six children with a severe hindfoot varus deformity due to CP (one female, aged 13.8 ± 2.3 years) and four typically developed (TD) adults (one female, aged 35.8 ± 4.8 years) were included. Personalized musculoskeletal foot models were created in OpenSim Creator [4] using WBCT scans. This foot was attached to the full-body OpenSim gait2392 model, which was scaled using gait analysis data. Muscle moment arms were calculated using OpenSim [5,6] and normalized to tibia length. A non-parametric Mann-Whitney U test was used to compare between groups. Normalized inversion-eversion moment arm lengths are shown in Fig. 1. The tibialis anterior had an inversion moment arm in the deformed CP feet, in contrast to an eversion moment arm in the TD group. No differences were found for the tibialis posterior. Although there was no overall group effect, the eversion moment arm of the peroneal muscles was smaller in most CP children compared to the TD group. Fig. 1 - Moment arms around the subtalar joint, normalized to tibia length. Note the different scales on the vertical axes. * p <.01.Download : Download high-res image (93KB)Download : Download full-size image We present the first study to evaluate altered moment arms in feet of children with CP using personalized musculoskeletal foot models based on WBCT scans. Our results indicate that the tibialis anterior becomes a more effective invertor with a varus deformity of the foot. Despite the fact that the tibialis posterior is often seen as an important cause of the varus deformity, its function as expressed by the moment arm does not change. On the other hand, the eversion moment arms of the peroneal muscles tend to become smaller, meaning they would be less effective in counterbalancing the deformity. Together, these altered moment arms would lead to an even larger varus moment in the subtalar joint with similar muscle forces, thereby pulling the foot even more towards varus. Our results could explain the progression of the deformity once the deformity is present.","PeriodicalId":94018,"journal":{"name":"Gait & posture","volume":"22 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135299039","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}