Ankle Dorsiflexor Function after Gastrocsoleus Lengthening in Children with Cerebral Palsy: A Literature Review
<i>Background and Objectives</i>: Ambulant children with cerebral palsy can demonstrate persistent “foot drop” after successful gastrocsoleus lengthening (GSL) surgery for equinus deformity. This may be due to inadequate strength and/or selective motor control of the ankle dorsiflexor mu...
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MDPI AG
2022-03-01
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| Series: | Medicina |
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| Online Access: | https://www.mdpi.com/1648-9144/58/3/375 |
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| author | Nicholas Sclavos Norine Ma Elyse Passmore Pam Thomason H. Kerr Graham Erich Rutz |
| author_facet | Nicholas Sclavos Norine Ma Elyse Passmore Pam Thomason H. Kerr Graham Erich Rutz |
| author_sort | Nicholas Sclavos |
| collection | DOAJ |
| description | <i>Background and Objectives</i>: Ambulant children with cerebral palsy can demonstrate persistent “foot drop” after successful gastrocsoleus lengthening (GSL) surgery for equinus deformity. This may be due to inadequate strength and/or selective motor control of the ankle dorsiflexor muscles. A procedure has been developed to reduce foot drop—Tibialis Anterior Tendon Shortening (TATS), to be performed in conjunction with GSL. However, it is currently unclear how ankle dorsiflexor function changes after surgery and which children could benefit from TATS. This review summarises changes in ankle dorsiflexor function after GSL for equinus, as reported in the literature. <i>Methods</i>: A search was performed of the Medline, Embase and PubMed databases from 1980 to 5 March 2021. Keywords included “cerebral palsy”, “equinus deformity”, “orthopedic procedures” and “gait analysis”. The search identified 1974 studies. Thirty-three cohort studies met the inclusion criteria for this review. <i>Results</i>: Twenty-two studies reported improvement in swing phase ankle dorsiflexion kinematics, after GSL. There was also evidence that clinical measures of ankle dorsiflexor strength improved after surgery. Four studies reported changes in selective motor control, with mixed results across the studies. <i>Conclusions</i>: There is good evidence that swing phase ankle dorsiflexion improves after GSL surgery. Although, there is limited evidence that this correlates with reduced foot drop or diminished need for an ankle-foot orthosis. Future research should be prospective, randomised, include a large sample size, and should focus on identifying the optimal candidates for TATS. |
| first_indexed | 2024-03-09T13:24:40Z |
| format | Article |
| id | doaj.art-bf91aaa66ba24f4689b491d9e001c873 |
| institution | Directory Open Access Journal |
| issn | 1010-660X 1648-9144 |
| language | English |
| last_indexed | 2024-03-09T13:24:40Z |
| publishDate | 2022-03-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Medicina |
| spelling | doaj.art-bf91aaa66ba24f4689b491d9e001c8732023-11-30T21:26:05ZengMDPI AGMedicina1010-660X1648-91442022-03-0158337510.3390/medicina58030375Ankle Dorsiflexor Function after Gastrocsoleus Lengthening in Children with Cerebral Palsy: A Literature ReviewNicholas Sclavos0Norine Ma1Elyse Passmore2Pam Thomason3H. Kerr Graham4Erich Rutz5Department of Paediatrics, The University of Melbourne, Melbourne, VIC 3052, AustraliaDepartment of Paediatrics, The University of Melbourne, Melbourne, VIC 3052, AustraliaHugh Williamson Gait Analysis Laboratory, The Royal Children’s Hospital, Melbourne, VIC 3052, AustraliaHugh Williamson Gait Analysis Laboratory, The Royal Children’s Hospital, Melbourne, VIC 3052, AustraliaDepartment of Paediatrics, The University of Melbourne, Melbourne, VIC 3052, AustraliaDepartment of Paediatrics, The University of Melbourne, Melbourne, VIC 3052, Australia<i>Background and Objectives</i>: Ambulant children with cerebral palsy can demonstrate persistent “foot drop” after successful gastrocsoleus lengthening (GSL) surgery for equinus deformity. This may be due to inadequate strength and/or selective motor control of the ankle dorsiflexor muscles. A procedure has been developed to reduce foot drop—Tibialis Anterior Tendon Shortening (TATS), to be performed in conjunction with GSL. However, it is currently unclear how ankle dorsiflexor function changes after surgery and which children could benefit from TATS. This review summarises changes in ankle dorsiflexor function after GSL for equinus, as reported in the literature. <i>Methods</i>: A search was performed of the Medline, Embase and PubMed databases from 1980 to 5 March 2021. Keywords included “cerebral palsy”, “equinus deformity”, “orthopedic procedures” and “gait analysis”. The search identified 1974 studies. Thirty-three cohort studies met the inclusion criteria for this review. <i>Results</i>: Twenty-two studies reported improvement in swing phase ankle dorsiflexion kinematics, after GSL. There was also evidence that clinical measures of ankle dorsiflexor strength improved after surgery. Four studies reported changes in selective motor control, with mixed results across the studies. <i>Conclusions</i>: There is good evidence that swing phase ankle dorsiflexion improves after GSL surgery. Although, there is limited evidence that this correlates with reduced foot drop or diminished need for an ankle-foot orthosis. Future research should be prospective, randomised, include a large sample size, and should focus on identifying the optimal candidates for TATS.https://www.mdpi.com/1648-9144/58/3/375cerebral palsyequinusgastrocsoleus lengtheningfoot dropgait analysis |
| spellingShingle | Nicholas Sclavos Norine Ma Elyse Passmore Pam Thomason H. Kerr Graham Erich Rutz Ankle Dorsiflexor Function after Gastrocsoleus Lengthening in Children with Cerebral Palsy: A Literature Review Medicina cerebral palsy equinus gastrocsoleus lengthening foot drop gait analysis |
| title | Ankle Dorsiflexor Function after Gastrocsoleus Lengthening in Children with Cerebral Palsy: A Literature Review |
| title_full | Ankle Dorsiflexor Function after Gastrocsoleus Lengthening in Children with Cerebral Palsy: A Literature Review |
| title_fullStr | Ankle Dorsiflexor Function after Gastrocsoleus Lengthening in Children with Cerebral Palsy: A Literature Review |
| title_full_unstemmed | Ankle Dorsiflexor Function after Gastrocsoleus Lengthening in Children with Cerebral Palsy: A Literature Review |
| title_short | Ankle Dorsiflexor Function after Gastrocsoleus Lengthening in Children with Cerebral Palsy: A Literature Review |
| title_sort | ankle dorsiflexor function after gastrocsoleus lengthening in children with cerebral palsy a literature review |
| topic | cerebral palsy equinus gastrocsoleus lengthening foot drop gait analysis |
| url | https://www.mdpi.com/1648-9144/58/3/375 |
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