Case
of the week - 01/09/98Case
of the week - 01/09/98This case is to be presented for discussion at the European Society for Movement Analysis in Children Annual Meeting in Belfast, 24th-26th September 1998.
Discussion is welcomed before the event. Address any comments to
CGA ([n/a]).
Case KA is a 6½ year old girl with mild Spastic Diplegia with asymmetrical involvement. She is an independent ambulator complaining of a (L) in-toeing gait with occasional tripping. She walks with a ‘jump-knee’ pattern bilaterally with a tendency to hyper-extension on the (L).
In the past she has been treated with serial casting for a tight (L) tendo-achilles with temporary benefit, has used a (L) DAFO and AFO which were discontinued because they increased internal rotation on this side, and has been considered for a (L) TA release by the referring Orthopaedic Surgeon. She currently uses a (L) night splint only.
On examination she has no fixed deformities at the hips
or knees and no fixed equinus. There is mildly increased femoral anteversion
(L) > (R). Duncan Ely test is mildly positive (L) > (R) and popliteal angles
are within normal limits. There is mild tendo-achilles tightness of the
(L) ankle which is correctable to plantigrade and a slightly adducted forefoot
correctable to neutral. The (L) peronei are weak. Ankle clonus is positive
on the (L) side only. Generally she has good muscle strength and excellent
selective control.
| R.O.M (R) | R.O.M (L) | Strength (R) | Strength (L) | |
| Hip flexion | FR | FR | 5 | 4 |
| Hip Extension (Thomas test) | -ve | -ve | 4 | 4 |
| Hip abduction (hip ext/knee flex) | 60 | 60 | ||
| Hip abduction (hip ext/knee ext) | 50 | 50 | 4 | 4 |
| Hip internal rotation | 70 | 90 | ||
| Hip external rotation | 30 | 20 | ||
| Knee flexion | FR | FR | 5 | 5 |
| Knee extension | 0 | 0 | 4 | 4 |
| Popliteal angle | 30 | 30 | ||
| Dorsiflexion (knee flexed) | 10 | 0 | 4 | 3+/4 |
| Dorsiflexion (knee extended) | 10 | 0 | ||
| Forefoot inversion | 4 | 4 | ||
| Forefoot eversion | 4 | 2 | ||
| Duncan Ely (Fast) | +ve | +ve | ||
| Ankle Clonus | -ve | +ve |
Temporal Parameters:
| Left | Right | |
| cadence (steps(min): | 147 | 147 |
| speed (m/s): | 1.03 | 1.01 |
| step length (m): | 0.44 | 0.39 |
Movies (PC users get the QuickTime plug-ins here - right mouse-click "Save Link as..." - Windows 95/NT and 3.1)
The movies will open in new browser windows so you can view them simultaneously
with analysis.
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|
frontal | |
| movie format | QuickTime | QuickTime |
| left side | front view | |
| right side | rear view |
3D
Kinematics right and left
3D
Kinematics repeatability left ... 3D
Kinematic repeatability right
... points for discussion:
What people said...
Case supplied by Richard
Baker
Case prepared by Mag. Andreas
Kranzl
Email your comments to [n/a]
Maintained by DDr.
Chris Kirtley, Andreas
Kranzl
Last modified on Wednesday, 13-August 1998.
