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A new approach in the clinical decision-making for cerebral palsy using three-dimensional subject-specific musculoskeletal reconstructions.

Type
Articles dans des revues avec comité de lecture
Author
MASSAAD, Abir
301405 Université Saint-Joseph de Beyrouth [USJ]
ASSI, Ayman
301405 Université Saint-Joseph de Beyrouth [USJ]
1001017 Institut de Biomecanique Humaine Georges Charpak [IBHGC]
BAKOUNY, Ziad
301405 Université Saint-Joseph de Beyrouth [USJ]
SKALLI, Wafa
1001017 Institut de Biomecanique Humaine Georges Charpak [IBHGC]
GHANEM, Ismat
301405 Université Saint-Joseph de Beyrouth [USJ]

URI
http://hdl.handle.net/10985/18101
DOI
10.12816/0031524
Date
2016
Journal
Lebanese Medical Journal

Abstract

Cerebral palsy (CP) is a neurological disorder which can cause muscular spasticity. Children with this condition suffer from a combination of gait deviations, skeletal deformities and muscular abnormalities. Precise evaluation of each of these three components is crucial for management planning in children with CP. The aim of this study is to review the latest innovative methods used for three-dimensional (3D) gait analysis and musculoskeletal modeling in children with cerebral palsy. 3D gait analysis is a quantitative objective method based on the use of infrared cameras. It allows the evaluation of dynamic joint angles, forces and moments applied on joints and is usually coupled with dynamic electromyography. Skeletal evaluation is usually based on two-dimensional X-rays and physical examination in clinical practice. However, a novel method based on stereoradiographic 3D reconstruction of biplanar low dose X-rays allows a more thorough evaluation of skeletal deformities, and in particular torsional anomalies. Muscular evaluation of children with CP is most commonly based on magnetic resonance imaging, whereby delimitation of lower limb muscles on axial slices allows 3D reconstruction of these muscles. Novel innovative techniques allow similar reconstructions by extrapolation, thus limiting the necessary quantity of axial slices that need to be manually delimitated.

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