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Relationship between isometric muscle strength, gait parameters, and gross motor function

Relationship between isometric muscle strength, gait parameters, and gross motor function. Ki Hyuk Sung, MD. Seoul National University Bundang Hospital. Introduction. Muscle weakness is a common impairment in patients with cerebral palsy

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Relationship between isometric muscle strength, gait parameters, and gross motor function

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  1. Relationship between isometric muscle strength, gait parameters, and gross motor function Ki Hyuk Sung, MD Seoul National University Bundang Hospital

  2. Introduction • Muscle weakness is a common impairment in patients with cerebral palsy • Lower limb muscle strength is reduced by 6%-59% compared with peers with typical development

  3. Introduction • Muscle strength had a significant association with gross motor function • Muscle strengthening exercise could result in functional improvements • Recent studies showed no improvement of functional activity after muscle strengthening training

  4. Introduction • No single study which investigates the relationship between muscle strength and gross motor function, gait kinematics, and gait kinetics in patients with CP

  5. Purpose of the study • To the correlation between isometric muscle strength and gross motor function, gait kinematics and kinetics in ambulatory patients with spastic CP

  6. Materials and Methods • Prospective design • Inclusion • consecutive ambulatory patients with spastic CP • patients who planned for single event multilevel surgery including DHL • preoperative 3D gait analysis and gross motor function measure (GMFM) scoring

  7. Measuring isometric muscle strength • Handheld dynamometer

  8. Measuring isometric muscle strength • Hip flexor muscle

  9. Measuring isometric muscle strength • Hip extensor muscle

  10. Measuring isometric muscle strength • Knee flexor muscle

  11. Measuring isometric muscle strength • Knee extensor muscle

  12. Gross motor function measure (GMFM) • 88 items within five dimension • Dimension D(standing) and E(walking, running, jumping) scoring • 3D gait analysis • Kinematic, kinetic and temporal parameters

  13. Reliability of strength measurement • Intra-session reliability, 3 trial • ICC (intraclass correlation coefficient) & 95% confidence interval

  14. Statistical analysis • Correlation between peak isometric strength and GMFM, gait kinematics and gait kinetics • Pearson’s correlation coefficient • Difference in peak isometric muscle strength according to GMFCS level • One-way analysis of variance (ANOVA)

  15. Results

  16. Conclusions • There is no correlation between muscle strength and gross motor function. • However, higher muscle strength, especially extensor muscle group of hip and knee joint, stabilizes the pelvic motion and makes walking more energy-efficient in flexed knee gait.

  17. Thank you !

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