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Three Dimensional Gait Analysis Following the Adeli Treatment for Cerebral Palsy: a Case Report Troy Lase Grand Valley State University

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Three Dimensional Gait Analysis Following the Adeli Treatment for Cerebral Palsy: a Case Report Troy Lase Grand Valley State University Grand Valley State University ScholarWorks@GVSU Masters Theses Graduate Research and Creative Practice 2001 Three Dimensional Gait Analysis Following the Adeli Treatment for Cerebral Palsy: A Case Report Troy Lase Grand Valley State University Follow this and additional works at: http://scholarworks.gvsu.edu/theses Part of the Physical Therapy Commons Recommended Citation Lase, Troy, "Three Dimensional Gait Analysis Following the Adeli Treatment for Cerebral Palsy: A Case Report" (2001). Masters Theses. 552. http://scholarworks.gvsu.edu/theses/552 This Thesis is brought to you for free and open access by the Graduate Research and Creative Practice at ScholarWorks@GVSU. It has been accepted for inclusion in Masters Theses by an authorized administrator of ScholarWorks@GVSU. For more information, please contact [email protected]. THREE DIMENSIONAL GAIT ANALYSIS FOLLOWING rhilE /llOEilLl ITREzjAnrMEzlSnr f:<:)R C:E:RE:IEIRLAI_ C/USE REF%)Prr Master's Thesis By Troy Lase Submitted to the School of Health Professions at Grand Valley State University Allendale, Michigan in partial fulfillment of the requirements for the degree of MASTER OF SCIENCE IN PHYSICAL THERAPY 2001 THESIS COMMITTEE ADVISOR APPROVAL: 4 « t ? ■ 1^.0 "S Chair: Gordon AlderihK, Ph D, P.T. Date Memppr: John Peck, Ph.D., P.T. Date Member: Cathy Harro, M.S., P.T., N.C.S. Date Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. THREE DIMENSIONAL GAIT ANALYSIS FOLLOWING THE ADELI TREATMENT FOR CEREBRAL PALSY: A CASE REPORT Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. ABSTRACT This case report describes the use of three-dimensional gait analysis to identify kinematic changes following the Adeli suit treatment. The suit's original design was to decrease the effects of weightlessness in space but has been modified to become the primary modality for the Adeli treatment used to treat cerebral palsy. Data were quantitatively produced by three-dimensional gait analysis before and after treatment were used to identity any changes in gait. Following the Adeli treatment, instrumented gait analysis showed that no clinically significant changes in four critical events of gait following the Adeli treatment occurred. 11 Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. ACKNOWLEDGEMENTS I would like to personally thank all of my committee members for allowing me the chance to finish this thesis and also the PT program at GVSU. The last couple years of my life have been to say the least very challenging. I am so very grateful for your help in assisting me to complete my dream. I also would like to thank all my friends and family especially Dan and Laura McCloud, Julie Parker, Steve Leppard, and Craig Vissers for all of their support through this process. A special thanks to my best friend Bret whose guidance, strength and support has helped me in ways that he cannot imagine. May God's light shine favorabie on each and everyone. Ill Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. DEFINITION OF TERMS Afferent Nerves: Nerve fibers that transmit impulses from the periphery toward the central nervous system. Agnosia: An inability to recognize sensory inputs (sight, sound, touch). The most common agnosia is a result of brain injury damaging the posterior aspect of the brain causing visual agnosia (inability to properly recognize objects by sight). Anoxia: An abnormal condition characterized by a lack of oxygen as a result from an inadequate supply of oxygen in the blood to carry oxygen to the tissue or for the tissue to absorb. Aoaar Scale: The evaluation of an infant's physical condition at birth performed at one and five minutes after birth and based on a rating of five factors that reflect the infant's ability to adjust to extrauterine life. Apraxia: A movement disorder due to brain damage that results in an inability to carry out preplanned voluntary sequences of movement. Ataxia: A disturbance in the rate, range force and duration of movement. Athetosis: A neuromuscular condition characterized by slow, writhing, and involuntary movement of the extremities as seen in forms of cerebral palsy and in motor disorders resulting from lesions in the basal ganglia. Basal Ganglia: A collection of nuclei at the base of the cerebral cortex which includes the caudate nucleus, the putamen, the globus pallidus and functionally include the substantia nigra and subthalamic nucleaus. Central Nervous System fCNS): The nervous system consisting of the brain, spinal cord and processes information to and from the peripheral nervous system and in the main neocortex for coordination and control for the entire body. Central Pattern Generator fCPGI: A network of neurons contained within the spinal cord identified in non-human vertebrates as being a center for generated locomotion without initiation of upper cerebrum input. Cerebral Cortex: A layer of neurons on the surface of the cerebral hemispheres which integrates higher mental function general movement, visceral functions, perception and behavioral reactions. Cerebellum: The posterior portion of the brain in the posterior aspect brain between the cerebrum and the brain stem, that is responsibie for coordinated voluntary muscular activity. IV Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. Cerebral Vascular Accident fCVA): The sudden death of some brain cells due to lack of oxygen when the blood flow to the brain is impaired by blockage or rupture of an artery to the brain. A CVA is also referred to as a stroke. Cerebral Palsy fCP): A syndrome of weakness, spasticity, poor coordination of the limbs and other muscles, impaired sensory perception, and sometimes impaired intelligence. The cause of cerebral palsy is not always known, although many cases are linked with lack of oxygen during birth. Chorioamnionltis: An inflammatory reaction in the amniotic membranes caused by bacteria or viruses in the amniotic fluid. Chorea: Ceaseless rapid complex body movements that look well coordinated and purposeful but are, in fact, involuntary and non-purposeful movements. Dvsdiadokinesia: An inability to perform rapid alternating movements such as rhythmically tapping the fingers on the knee. Dvsmetria: An inability to gauge distances accurately combined with the inability to control a muscular movement at the desired point. Dystonia: Involuntary movements and prolonged muscle contraction, resulting in twisting body motions, tremor, and abnormal posture. These movements may involve the entire body, or only an isolated area. Some types of dystonia respond to dopamine, or can be controlled with sedative-type medications, or surgery. Efferent Nerves: Nerve that transmits impulse away from the central nervous system usually causing a muscle contraction or release of glandular secretion. ElectromvographyfEIVIG): A reading or tracing of the electrical signal elicited by a muscle during contraction. Extrapvramldal System: T he part of the nervous system that include the basal nuclei, substantia nigra, subthalamus parts of the midbrain and the motor neurons of the spine. Extremely low birth weight baby (ELBW): A baby bom very prematurely weighing between 401 and 1000 grams at birth. Extremely low birth weight (ELBW) babies are at the lower limits of viability. Festinating: A manner of walking in which a person's speed increases in an unconscious effort with a displaced center of gravity and base of support. Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. Floppy Baby Syndrome: A general medical reference to an abnormal condition of newborns and infants manifested by inadequate tone of the muscles. It can be due to a multitude of different neuralgic and muscle problems. Hypotonia: Decreased tone of skeletal muscles. In a word, floppiness. Hypotonia is a common finding in cerebral palsy and other neuromuscular disorders. Hypertonia: Increased resting muscle tone. Untreated hypertonia can lead to loss of function and deformity. Treatment is by physical and/or occupational therapy, and in some cases muscle relaxant medication. Hyperbaric Medicine: Hyperbaric oxygenation is an increased amount of oxygen in organs and tissues resulting from the administration of oxygen in a compression chamber at an ambient pressure greater than 1 atmosphere. Incidence Rate: T he frequency with which something, such as a disease or trait, appears in a particular population or area. Intention Tremors: Fine rhythmic purposeless movements that tend to increase during voluntary movements. Low birth Weight Infant (LBW): A baby bom prematurely weighing between 2500 and 1501 grams at birth. Low birth weight (LBW) babies are at the upper limits of viability. Lower Motor Neuron: A neuron originating in the motor nuclei of the spinal cord or brainstem and providing innervations to motor units of skeletal muscle. Motor Control: The ability of the CNS to regulate and / or direct the musculoskeletal system in purposeful acts. Muscle Spindles: A sensory receptor found in muscle fibers that are sensitive to changes in muscle length and rate of change during movement and stretch. Multiple Sclerosis (MS): A progressive neurological disorder characterized by the demyelinization of the white matter sometimes extending into the gray matter. Impaired bodily functions or altered sensations
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