Course No. 6
GAIT PATTERNS AND FUNCTIONAL MOBILITY FOR CHILDREN WITH CEREBRAL PALSY: A MULTIDISCIPLINARY APPROACH IN MANAGEMENT
Location: Dan Panorama Hotel Tel Aviv (Conference Hotel)
Tom F. Novachek, MD Medical Director, James R. Gage Center for Gait and Motion Analysis, Gillette Children's Specialty Healthcare, St. Paul, MN, USA
Marcie Ward, MD, Pediatric Rehabilitation, Gillette Children's Specialty Healthcare, St. Paul, MN, USA
The history of treatment of gait and functional mobility impairment due to cerebral palsy has been fragmented and typically orthopedic in nature with repeated tendon lengthenings serially over the course of a child’s years of development. There was too much adductor, hamstring, and heelcord lengthening surgery.
New developments over the past few decades include:
advent of botulinum toxin
new methods for physical therapy and orthosis fabrication and design
repopularization of selective dorsal rhizotomy (SDR)
switching the orthopedic focus from muscle tendon lengthening to lever arm deformity correction using the concept of single event multilevel surgery (SEMLS)
development and incorporation of computerized three-dimensional motion analysis
This modern treatment paradigm is orchestrated by multidisciplinary care teams utilizing and supported by gait analysis data.
This course will focus on these recent developments and explore how they can be instituted using the multidisciplinary approach to a child’s care including the roles of physiatry, orthopedics, and neurosurgery in conjunction with the work of the rehabilitation team and orthotists. Since knowledge of the natural history of the condition and the effectiveness of interventions must be the basis for decision-making, short and long term outcomes of SDR, SEMLS, and distal femoral extension osteotomy + patellar tendon advancement (DFEO/PTA) will be presented. Case studies will be used to highlight key concepts.