geoscience.net logo
+ Resolve Article
+ Follow Us
Follow on FacebookFollow on Facebook
Follow on TwitterFollow on Twitter

+ Translate
+ Subscribe to Site Feed
GeoScience Most Shared ContentMost Shared Content

A cohort study of tibialis anterior tendon shortening in combination with calf muscle lengthening in spastic equinus in cerebral palsy


, : A cohort study of tibialis anterior tendon shortening in combination with calf muscle lengthening in spastic equinus in cerebral palsy. Gait & Posture 50(): 23-27

NlmCategory="UNASSIGNED">The aim of this study was to evaluate the outcome of combined tibialis anterior tendon shortening (TATS) and calf muscle-tendon lengthening (CMTL) in spastic equinus. Prospectively collected data was analysed in 26 patients with hemiplegic (n=13) and diplegic (n=13) cerebral palsy (CP) (GMFCS level I or II, 14 males, 12 females, age range 10-35 years; mean 16.8 years). All patients had pre-operative 3D gait analysis and a further analysis at a mean of 17.1 months (±5.6months) after surgery. None was lost to follow-up. Twenty-eight combined TATS and CMTL were undertaken and 19 patients had additional synchronous multilevel surgery. At follow-up 79% of patients had improved foot positioning at initial contact, whilst 68% reported improved fitting or reduced requirement of orthotic support. Statistically significant improvements were seen in the Movement Analysis Profile for ankle dorsi-/plantarflexion (4.15°, p=0.032), maximum ankle dorsiflexion during swing phase (11.68°, p<0.001), and Edinburgh Visual Gait Score (EVGS) (4.85, p=0.014). Diplegic patients had a greater improvement in the EVGS than hemiplegics (6.27 -vs- 2.21, p=0.024). The originators of combined TATS and CMTL showed that it improved foot positioning during gait. The present study has independently confirmed favourable outcomes in a similar patient population and added additional outcome measures, the EVGS, foot positioning at initial contact, and maximum ankle dorsiflexion during swing phase. Study limitations include short term follow-up in a heterogeneous population and that 19 patients had additional surgery. TATS combined with CMTL is a recommended option for spastic equinus in ambulatory patients with CP.

US$19.90

PMID: 27559938

DOI: 10.1016/j.gaitpost.2016.08.015


Other references

Voiculescu, A.; Cazacliu, A.; Voiculescu, S., 1968: Circulatory, respiratory and metabolic equilibrium tests during and after physical activity in cardiovascular disease patients. Fiziologia Normala Si Patologica 14(5): 427-436

Filipov M.M., 1975: Oxygen regimes in the body of teenagers and men during dynamic muscular activity. Fiziolohichnyi Zhurnal (Kiev) 21(2): 229-237

Newberry, K.; Jansen, E.J.; Thibaud, G.R., 1987: The occurrence of the bedbugs Cimex hemipterus and Cimex lectularius in northern Natal and KwaZulu, South Africa. Two species of anthropophilic bedbugs, Cimex lectularius and C. hemipterus, infest dwellings in KwaZulu, the known range of the latter extending to 28 degrees 15'S. C. hemipterus is the more common species in KwaZulu north of 27 degrees 15&ap...

Zhang, Y.; Bing, G.; Filer, D.; Stone, E.A., 1992: Effect of locus coeruleus lesion on c-fos response to metrazol in rat brain. Society for Neuroscience Abstracts 18(1-2): 1375

Key, D., 1972: The Stanswood Bay oyster fishery. Shellfish Information Leaflet, 25, 1-14

Cashwell, A.; Tantri, A.; Schmidt, A.; Simon, G.; Mistry, N., 2016: BRICS in the response to neglected tropical diseases. Bulletin of the World Health Organization 92(6): 461-462

Martinetto, P.; Daglio, C.; Cavallo, G., 1972: Certain aspects of Pneumocystis carinii from patients who died from interstitial plasmacellular pulmonitis. Giornale di Batteriologia, Virologia, Ed Immunologia Ed Annali Dell'ospedale Maria Vittoria di Torino 65(5): 135-139

Makowski, A.L., 2015: The Ethics of Using the Recently Deceased to Instruct Residents in Cricothyrotomy. Cricothyrotomy is a rare but crucial procedure in the armamentarium of the emergency physician. The infrequency with which it is performed has led to a reliance on models, simulators, and animals in resident education, but each of these methods ha...

Cabral, H.O.; Fouquet, C.; Rondi-Reig, L.; Pennartz, C.M.A.; Battaglia, F.P., 2015: Single-trial properties of place cells in control and CA1 NMDA receptor subunit 1-KO mice. The NMDA receptor plays a key role in synaptic plasticity and its disruption leads to impaired spatial representation in the CA1 area of the hippocampus, with place cells exhibiting larger place fields (McHugh et al., 1996). Place fields are defin...

Law, R.; Perez-Miranda, M., 2017: Is it time to stop using percutaneous transhepatic biliary drainage?. Endoscopy 49(6): 521-523