The effect of treating foot deformity on motion, loading and the efficiency of gait in cerebral palsy
Nicola Alder and Noel McCarthy with Tim Theologis, Julie Stebbins and Marian Harrington (Oxford)
Amongst other problems, foot deformity affects over 90% of children with cerebral palsy and can severely affect their walking. With the current limited understanding of the normal and pathological foot during gait, treatment of foot deformity in cerebral palsy remains mainly empirical. This study aims to progress the understanding of the problems in pathological feet and to establish objective criteria for the treatment of foot deformities in children with cerebral palsy (CP).
This study proposes to apply a recently developed multi-segment foot model to measure movements within the foot during walking. These measurements will be combined with those of conventional lower limb kinematics and kinetics during gait that are synchronised with plantar pressure measurements. In addition, muscle activity and energy expenditure will be monitored.
15 healthy children will be recruited in order to study the inter and intra-subject repeatability of foot motion and pressure measurements in the healthy foot. Normal ranges for each variable will be obtained. The main study involves 15 CP children who are candidates for foot surgery, and 15 who are not. The surgical group will be assessed pre surgery and will be followed up at 6 and 12 months post surgery. The conservative treatment group will be assessed at similar intervals. Variables that fall outside the established normal ranges will be identified and thus provide a basis for future criteria for the treatment of foot deformities in children with CP.
