This 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
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
|R.O.M (R)||R.O.M (L)||Strength (R)||Strength (L)|
|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|
|Dorsiflexion (knee flexed)||10||0||4||3+/4|
|Dorsiflexion (knee extended)||10||0|
|Duncan Ely (Fast)||+ve||+ve|
|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
|left side||front view|
|right side||rear view|
3D Kinematics repeatability left ... 3D Kinematic repeatability right
3D Kinetics right and left
EMG left ... EMG right
... points for discussion:
Case supplied by Richard
Case prepared by Mag. Andreas Kranzl
Email your comments to [n/a]
Maintained by DDr.
Chris Kirtley, Andreas
Last modified on Wednesday, 13-August 1998.
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