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2. AUGMENTATION OF
WALKING ABILITY
ACTUALISATION OF AMBULATORY
POTENTIAL
SAFETY IN AMBULATION
ENERGY CONSUMPTION
NORMALISATION OF WALKING
PATTERN
10. COMMON PATTERN
OF GAIT
JUMP GAIT
CROUCH GAIT
STIFF GAIT
RECURVATUM GAIT
SCISSORING GAIT
INTOEING AND OUT-TOEING
11. FOCUS OF ORTHOPAEDIC
INTERVENTIONS
• TO REDUCE SPASTICITY
• TO CORRECTION OF DEFORMITIES
• TO UPGRADE FUNCTIONAL LEVELS
TO IMPROVE GAIT PARAMETERS
STABILITY OF LIMB IN STANCE
CLEARANCE IN SWING
EFFECTIVE SHIFTING
SEQUENCING
PREVENTION OF SECONDARY AND TERTIARY
DEFICIENCIES
COSMETIC
NON-AMBULATORS PROVIDING WIDE BASE
FOR PROPER SITTING AND POSITIONING
12. IMPORTANCE OF MULTI
JOINT PARAMETERS
SEVERITY OF THE SPASTICITY AND
DEFORMITY MORE IN MJM
EFFECT ON PROXIMAL AND DISTAL
JOINT
UNMASKING OF SPASTICITY EFFECT ON
ARTICULAR PERIARTICULAR
STRUCTURES
44. SURGICAL OPTIONS
• STAHELI PROPOSES FDO
IF AV > 50O
• INTERNAL HIP ROTATION OF
> 85O
• EXTERNAL HIP ROTATION OF
< 10O
45. DISLOCATION OF HIP IN CHILDREN
WITH CEREBRAL PALSY
• RISK OF LATERAL DISPLACEMENT
- 7% IN AMBULATORY
- 60% IN NON-AMBULATORY
• CAUSE : PAIN
CONTRACTURES
PROBLEMS WITH SITTING,
STANDING AND WALKS
FRACTURES
SKIN ULCERATIONS
• ACETABULARY INDEX < 30%
• MIGRATION PERCENTAGE < 33%
71. • TIBIAL TORSION
• DEROTATION OSTEOTOMY
• HALLUX VALGUS
• FUSION OF MP JOINTS
72.
73.
74. CLASSIFICATION OF HEMIPLEGIC GAIT
(WINTER, GAGE, HIKES)
GROUP I – DROP FOOT DURING SWING PHASE
OF GAIT
GROUP II – EQUINUS IN BOTH STANCE AND SWING
PHASE OF GAIT BECAUSE OF FIXED
EQUINUS CONTRACTURE
GROUP III - INVOLVEMENT AT THE KEE WITH A
LEXED STIFF KNEE GAIT
GROUP IV – INVOLVE HIP WITH INCREASED
FLEXION AND REDUCED AT BOTH HIP,
KEE AND EQUINUS AT ANKLE
DRAW BACKS:- BASED ON DATA RELEVANT TO SAGITTAL
PLANE ONLY WHEREAS SIGNIFICANT
ABNORMALIITIES OCCUR IN CORONAL PHASE AND
TRANSVERSE PLANE