ESMAC 2012 abstract / Gait & Posture 38 (2013) S1–S116 S63

Discussion and conclusions: Takken [4] concludes in his reviewthat exercise therapy didn’t show statistically significant effectson functional abilities and therefore claims standardized therapy.PMW is a standardized approach to treat certain deficits in motorabilities of patients with JIA. The results here indicate that PMWshows effects on the JIA patients. The improvement of flexibilityand the moderate effect size of the core stability are indicators offurther research on this topic. The patients report no detrimentaleffects due to the intervention. The next steps are to enlarge thesample sizes and to analyze long-term effects.

Acknowledgement

The authors wish to thank “Kinder-Rheumastiftung” for fundingthis study.

References

[1] Singh-Grewal D. Arthritis & Rheumatism 2007;57(7):1202–10.[2] Hartmann M. International Journal of Pediatrics 2010, pii: 835984 (Epub 2010

Sep 2.).[3] Brostrom E. Archives of Physical Medicine and Rehabilitation

2004;85(8):1224–30.[4] Takken T. The Journal of Rheumatology 2002;29(12):2643–7.

http://dx.doi.org/10.1016/j.gaitpost.2013.07.138

P17

Premature ankle plantarflexor activity duringgait: An evaluation of 647 patients with diversepathologies

Jacqueline Romkes, Katrin Schweizer, ReinaldBrunner

University Children’s Hospital Basel, Laboratory forMovement Analysis, Basel, Switzerland

Introduction: Premature plantarflexor muscle activity (PPF)during the first 10% of the gait cycle in walking is a common devi-ation observed in patients with diverse pathologies. Among theaetiological factors are biomechanical alterations and/or muscu-

Fig. 1. The figure shows the number of patients with premature plantaflexor activ-ity (PPF) for the seven pathological groups: OUni/OBi: orthopaedic uni-/bilateral;NflaUni/NflaBi: neurological flaccid uni-/bilateral; NspUni/NspBi/NspBiNTC: neu-rological spastic uni-/bilateral with/without adequate trunk control.

lar weakness [1,2]. The aim of this study was to evaluate if thesefactors for PPF are independent of the pathology.

Patients/materials and methods: Gait analysis data of 647patients were investigated retrospectively. Seven pathologi-cal groups were defined: orthopaedic uni-/bilateral (OUni/OBi);neurological flaccid uni-/bilateral (NflaUni/NflaBi); neurologi-cal spastic uni-/bilateral with/without adequate trunk control(NspUni/NspBi/NspBiNTC). PPF was defined as constant m. gas-trocnemius surface EMG activity during 0–10% of gait cycle thatexceeded 28%, 23% and 31% of peak activity calculated over theentire gait cycle. The gait profile score (GPS) [3] was calculated as ameasure of overall gait deviation. Manual muscle strength (MMS,scale: 0–5 with 5 = normal) of the leg muscle groups [4] was testedand averaged across the muscles to detect muscle weakness.

Results: The number of patients with PPF in each group andthe subgroups ‘normal MMS’ (≥4.5), ‘reduced MMS’ (<4.5), ‘normalGPS’ (≤7.3◦), and ‘abnormal GPS’ (>7.3◦) are shown in Fig. 1. PPF ismore frequent in patients with reduced MMS/abnormal GPS thanin patients with normal MMS/GPS, except for the NflaUni group(may be biased by the small group size).

Discussion and conclusions: PPF is an abnormality with clin-ical relevance, as its prevalence is more than 10% in each patientgroup. Muscle strength and kinematic deviations both seem to beamong the aetiological factors, independent of the pathology. Con-sequently, PPF should rather be regarded as a secondary deviationthan a primary abnormality.

Acknowledgement

Swiss National Science Foundation (SNF): 32003B 127534.

References

[1] Romkes J, Brunner R. Gait & Posture 2007;26:577–86.[2] Brunner R, Romkes J. Gait & Posture 2008;27:399–407.[3] Baker R, et al. Gait & Posture 2009;30:265–9.[4] Hislop HJ, Montgomery J. Manuelle Muskeltests 1999.

http://dx.doi.org/10.1016/j.gaitpost.2013.07.139

P19

3D gait assessment in children with cerebralpalsy using foot-worn inertial sensors

Christopher J. Newman 1, Benoit Mariani 2, AlineBrégou Bourgeois 3, Pierre-Yves Zambelli 3,Kamiar Aminian 2

1 Lausanne University Hospital, Pediatric Neurologyand Neurorehabilitation Unit, Lausanne, Switzerland2 Ecole Polytechnique Fédérale de Lausanne,Laboratory of Movement Analysis and Measurement,Lausanne, Switzerland3 Lausanne University Hospital, PediatricOrthopedics and Traumatology Unit, Lausanne,Switzerland

Introduction: Generally, spatio-temporal gait analysis requiresdedicated laboratories with complex systems such as opticalmotion capture. It is likely that a child’s natural gait pattern maybe affected by a short distance walkway and the laboratory setting.Recently, ambulatory devices have overcome some of these limi-tations by using body-worn sensors measuring and analyzing gaitkinematics.

The aim of this study was to explore the use of foot-worn inertialsensors as a 3D gait measurement tool during a 200-meter walkingtest in independently walking children with cerebral palsy (CP).