Case of the Week 2/12/99: right hemiparesis

from The Hong Kong Polytechnic University & Tuen Mun Hospital, Hong Kong 

Animation by Polygon

Clinical Details

4.5 yo female. Normal birth history and healthy postnatally. Walking at 1 year, but was noticed to fall frequently. Analyzed prior to Botox injection of the right gastrocnemius.

Range of Motion (all measurements in degrees)

Joint
Sagittal (R; L) ext-neut-flex
Frontal (R; L) ab-neut-ad
Transverse (R; L) ext-neut-int
Hip 30-0-140; 30-0-140 60-0-30; 60-0-30 abduction, hip @ 90: 90; 90 
prone: 90-0-88;70-0-88
Knee 5-0-150; 5-0-150 
SLR: 68; 70 
Grab (hip @ 90): 10; 0 
Ely: -ve; -ve
Ankle Knee extended: 15-0-60; 45-0-60 
Knee flexed: 20-0-60; 50-0-60

Muscle Tone (Ashworth-Bohannon)

Group Right Left
Hip adductors 1 1
Knee extensors 1 1
Knee flexors 2 1
Plantarflexors 2 (no clonus) 1
(1 = normal, 2 = slight increase with catch)

Manual Muscle Test

Joint
Muscle
Right
Left
Hip  flexors 
extensors 
abductors 
adductors



5



5
Knee flexors 
extensors

4-
4+ 
4+
Ankle dorsiflexors 
plantarflexors
4- 
4-
4+ 
4+
Toe extensors 
flexors
4- 
4-
4+ 
4+

Movies

 
Right
Left
Front
Back
QuickTime right.mov left.mov front.mov back.mov
AVI right.avi left.avi front.avi back.avi

Motion Analysis

Right
Left
Right/Left
Velocity 0.77 m/s
Stride Length 0.71 m
Step Length 0.31 0.37 m
Cadence 138 129 123 st/min
Kinematics rkinem.jpg lkinem.jpg kinem.jpg
Kinetics rkinet.jpg lkinet.jpg kinet.jpg
EMG remg.avi (animation) lemg.avi (animation) emg.jpg


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Case prepared by Dr. Chris Kirtley & referred by Nerita Chan

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