CONGRESS 21st Annual Meeting of ESMAC Stockholm programme 13-15 september 2012

Septemberst 15-17, 2012 Stockholm,21 Annual Sweden Meeting of ESMAC www.esmac2012.com

September 13-15, 2012 Stockholm, Sweden www.esmac2012.com Welcome to the 21st Annual Meeting of ESMAC 13–15 september 2012 Stockholm, Sweden

21st Annual Meeting of ESMAC Stockholm 13-15 september 2012 WELCOME WORDS 5 CONGRESS VENUE 6 REGISTRATION 6 INSTRUCTIONS FOR ORAL PRESENTERS 7 INSTRUCTIONS FOR POSTER PRESENTERS 7 CONGRESS INFORMATION 8 Certificate of Attendance 8 Conference Language 8 First Aid 8 Cloakroom 8 Important contacts 8 Insurance and liability 8 Internet Access 9 Name Badges 9 Messages 9 Venue 9 Address 9 To the airport 9 PRACTICAL INFORMATION 10 Currency 10 Public transportation 10 Weather 10 Electricity 10 Time 10 Useful Telephone Numbers 10 Banks, Currency and Credit Cards 11 Shopping 11 Tipping 11 SOCIAL PROGRAMME 12 GENERAL INFORMATION ABOUT STOCKHOLM 13 VISIT STOCKHOLM 14 The Vasa Museum 14 Discover Stockholm by boat! 14 The Royal Palace of Stockholm 14 The Old Town 15 Visit “Artipelag” 15 THURSDAY, SEPTEMBER 13, 2012 19 Session 1, Children Orthopeadics 19 Baumann lecture, Carlo Frigo 25 Session 2a, Imaging methods 27 Session 2b, Knee Osteoarthritis 27 Keynote speaker I, Tim Theologis 37 Session 3a, Cerebral Palsy Descriptive 40 Session 3b, Technical and Simulation 41 FRIDAY, SEPTEMBER 14, 2012 64 Session 4a, Orthotics 64 Session 4b, Adult Orthopeadics 65 Session 5a, Upper extremity 78 Session 5b, Foot 79 Keynote speaker II, Hans Forssberg 99 Session 6a, Cerebral Palsy Effect 100 Session 6b, Gait assessment 101 SATURDAY, SEPTEMBER 15, 2012 122 Session 7, Balance and Posture 122 Keynote speaker III, Charlotte Häger 129 Session 8, Cerebral Palsy Spasticity, Muscle, Gait 131 POSTERS 142 Thursday 142 Friday 144 INDEX OF AUTHORS 253 COMMERCIAL EXHIBITION 270 Exhibition open hours 270 List of exhibitors 270 FLOORPLAN EXHIBITION HALL 271 FLOORPLAN STOCKHOLM WATERFRONT CONGRESS CENTRE 272 DEAR MEMBERS, COLLEGUES AND FRIENDS Supported by

a warm welcome to the 21st Annual Meeting of the European Society of Movement Analysis for Adults and Children (ESMAC). The congress is suitable for those interested in the clinical and technical aspects of movement analysis. This multidisciplinary congress provides a forum for researchers and clinicians involved in clinical gait analysis. Presentations will cover State of the Art developments in movement analysis for adults and children, new methodologies and developing expertise in clinical decision making. Our pre-congress gait analysis basic course (September 10-12) Platinum sponsor and a two day advanced course (September 11-12) are aimed at

beginners and experienced professionals. The courses will be held at Karolinska University Hospital and the congress will be held at the Stockholm Waterfront Congress Centre, which is located ideally in the heart of the city. This new congress center will accommodate everything from the welcome reception, coffee breaks, lunches, posters and exhibitions in the same area. Stockholm enjoys the benefits of a world-class transport Silver sponsor infrastructure, and people come here for the food, the design and the music. It also offers a unique range of galleries and museums, and every year the eyes of the world are on the city when the Nobel Prizes are awarded. Stockholm combines the charm of a small, old town with the cultural and commercial attractions of a big, modern city and is ranked as one of the most popular congress destinations in the world. We are certain that this will be a memorable and enjoyable meeting. Welcome to ESMAC 2012 in Stockholm.

PhD. PT, Eva W Broström PhD. ir. Jaap Harlaar Congress President President ESMAC

3 WELCOME WORDS BY FILIPPA REINFELDT

Dear Participants, A warm welcome to Stockholm and Sweden!

You have chosen an interesting and exciting time to visit us since Sweden, and Stockholm in particular, is expanding its efforts in medical research and technology. Stockholm has been the birthplace of many well known pharmaceuticals and medical equipment and now our goal is set even higher.

Stockholm county council is currently underway of building a new top modern hospital. This new hospital, Karolinska Universtetssjukhuset, will be the center of medical research and development in Sweden. As Stockholm County Health Commissioner it is of great importance to me that all citizens have equal right and equal opportunity to seek and receive medical treatment. But also to pave the way of future medical treatment and assist the research community in developing even smarter and more patient safe equipment and more effective medicine.

I sincerely hope that you will enjoy an eventful Annual Meeting and together with lively discussions grow even stronger as an organization. Hopefully you will have the time to see some of the beautiful and interesting sights of Stockholm before you leave.

Best of luck to you and the conference!

Filippa Reinfeldt Healthcare Commissioner of Stockholm County Council

4 CONGRESS VENUE Stockholm Waterfront Congress Centre Nils Ericsons Plan 4 111 64 Stockholm Sweden Tel +46 (0)8 50 50 6000 www.stockholmwaterfront.com

REGISTRATION The registration desk, located at Stockholm Waterfront Congress Centre will be open at the following hours: Wednesday 12 September 15.00 – 19.00 Thursday 13 September 08.00 – 18.00 Friday 14 September 08.00 – 18.00 Saturday 15 September 08.00 – 13.00

Telephone during opening hours: +46 (0)8 505 067 80

Included in registration The registration fee for the meeting includes the following: - admission to all meeting sessions, poster sessions and exhibition - program and abstract books - access to the welcome reception - coffee, tea and lunch during the meeting breaks

5 INSTRUCTIONS FOR ORAL PRESENTERS Preview Centre Presentations will be performed using PowerPoint file format on Windows PC (MS Office 2010). Only digital material will be allowed for podium presentations. In the interests of time-keeping, we recommend no more than one slide per minute.

Presentations should be provided on a USB-removable drive to the Preview Centre. Due to time and technical restraints during the sessions, personal laptops may not be used in the session rooms.

You are kindly asked to come to the Preview Centre and check-in your presentation (on your USB-removable drive), no later than 3 hours before the start of the session during which you will give the presentation. If your session starts early in the morning, please check-in your presentation in the afternoon of the preceding day.

Opening Hours Preview Centre Wednesday 12 September 18.00 – 19.00 Thursday 13 September 08.00 – 18.00 Friday 14 September 08.00 – 18.00 Saturday 15 September 08.00 – 09.00

Presentations Each presenter must make him/herself known to the chairpersons, who will mode- rate your session, shortly before the start of the session (if the session is preceded by a keynote, before that moment). Note that the speaking time is 8 minutes + 2 minutes for questions and discussion.

INSTRUCTIONS FOR POSTER PRESENTERS Posters should be up between Thursday 13th 09.00 and Friday 14th 14.30 in the exhibition hall. You can put up your poster Wednesday September 12th between 18.00-19.00 or Thursday between 08.00-09.00 in the exhibition hall. Please check your poster number in the program (available onsite) and mount your poster at your assigned position. Material for temporarily attaching posters to boards will be provided onsite. Posters should be taken down no later than Friday 14th at 19.00.

The interactive poster session will be held on Thursday, September 13th from 13.00–14.30 (odd numbers on blue poster note) and Friday September 14th 13.00–14.00 (even numbers on yellow poster notes). No other session or lecture is held during the poster sessions. Presenting the poster means that the author is available for information, questions and discussions for the whole session.

6 CONGRESS INFORMATION

Certificate of Attendance Your Certificate of Attendance will be included in your conference material available at the registration desk.

Conference Language The official language of the meeting is English. No simultaneous interpretation will be provided.

First Aid If needed, please contact the staff at the registration desk or dial 112.

Cloakroom Outerwear and luggage can be stored in the cloakroom in the main entrance hall.

Important contacts Organizer & Scientific Secretariat Official PCO, Sponsorship & Astrid Lindgren Children’s Hospital Exhibition Management at Karolinska University Hospital Arrangera Nöje & Konferens AB Karolinska Institutet Tegnérgatan 45, Motion Analysis Laboratory Q2:07 111 61 Stockholm, Sweden 117 76 Stockholm, Sweden Project Manager: Maria Ekdahl Phone: +46 (0)8 517 77 636 Telephone: +46 (0)8 545 833 40 Fax: +46 (0)8 517 77 349 Fax: +46 (0)8 545 83 349 Email: [email protected] Email: [email protected]

Insurance and liability The organisers cannot be held responsible for any personal injury, loss, damage or accident to private property, or for additional expenses incurred as a result of delays or changes in air, rail, road or other services, strikes, illness, weather and other causes. All participants are encouraged to make their own arrangements for health and travel insurance.

7 Internet Access Wireless LAN (W-LAN) will be available for free for all participants and exhibitors. UserID: esmac Password: esmac

Name Badges All participants are requested to wear their name badge during the congress and social programme. The access to the Scientific Programme and social events is restricted to those who have registered and wear their badges.

The following badges colours are used at the conference:

BaSIC GAIT COURSE advanced gait course congress staff exhibitors press

Messages Messages to delegates should be handed in at the registration desk. Notification of message receipt will be displayed on the message board next to registration desk. Please check the board daily and pick up your messages – they may be urgent.

Venue Stockholm Waterfront Congress Centre is located in the city center and close to the Central Station. It is only 20 min by train from Arlanda airport.

Address Stockholm Waterfront Congress Centre Nils Ericsons Plan 4 111 64 Stockholm, Sweden

To the airport Airport buses are cheaper, but Arlanda Express trains are climate smart and much faster. It’s also easy to get fixed-price taxis to and from Stockholm’s airports or to rent cars.

8 PRACTICAL INFORMATION

Currency The official currency in Sweden is Swedish Crowns (SEK). As an indication only: the recent historical exchange rate was around 100 SEK = 12 Euro.

Public transportation You can travel with public transportations throughout the Greater County of Stockholm. The area covers a distance of several kilometres outside the actual city centre and includes all services on the Metro, commuter rail, light railways such as the Roslagsbanan, Saltsjöbanan, and the Lidingöbanan trains, and hundreds of bus lines. Tickets are sold via their agents, at the SL Center and at commuter train stations. Some tickets can also be bought at the Metro barriers. There are also ticket machines at most Metro and commuter railway stations, as well as in a number of other locations. You can even buy a zone ticket which is sent as a text message to your mobile phone. It is always cheaper to buy prepaid tickets and the longer the period of validity of the ticket, the cheaper it will be per day. For short visits there are travelcards for 1, 3 or 7 days.

Weather Average high temperatures in Stockholm in September are around 15º C by day and nights are cooler. For detailed weather information, please visit www.SMHI.se

Electricity The main voltage in Sweden is 220V.

Time Stockholm is in the Central European Time Zone, two hours ahead of Greenwich Mean Time (GMT), still during daylight saving time.

Useful Telephone Numbers Emergency: 112 Taxi: +46 (0)8 15 00 00 (Taxi Stockholm) or +46 (0)8 30 00 00 (Taxi Kurir) Stockholm Tourist Center: +46 (0)8 508 28 508

9 Banks, Currency and Credit Cards Most Swedish banks will change traveller’s cheques as well as cash. Banking hours in general are Monday-Friday 08.00-15.00, although some banks are open later. ATMs are located outside most banks, and cash can be withdrawn there 24/7. National and foreign Maestro cards (debit cards) as well as Mastercard, AMEX, Visa and Diners are accepted. Forex operates a large number of foreign exchange bureaus in central location. Credit cards are also accepted by most hotels, restaurants, cafés, shops, taxis and gas stations.

Shopping Most shops are at least open from Monday to Friday 10.00-18.00 and Saturday 10.00-15.00. However, many shops and department stores in the central parts of the city are open longer hours as well as on Sundays.

Tipping Service is usually included in the prices in bars and restaurants. For exceptional service, tip an extra 5-10%.

PROUD SPONSOR OF ESMAC 2012

We help more people to a better life

At TeamOlmed in Solna, you will find our specialized center for children. Our team of CPO’s and technicians has great experience in prescribing, developing and manufacturing orthopedic devices for children and adolescences. For clinical analysis and evaluation of our products’ effect on the patients’ gait, we use a 2-dimensional motion analysis system with a force plate. With close cooperation of parents, medical doctors, physical therapists and occupational therapist we commit to always fulfill the child’s needs seen from a complete perspective.

www.teamolmed.se

10 SOCIAL PROGRAMME

Congress Welcome Reception on Wednesday, September 12, 2012 at 19.00–21.00 Reception for registered participants, accompanying persons and exhibitors take place at Stockholm Waterfront Congress Centre. Tickets are included in the regular fee for participants. Extra tickets for exhibitors and accompanying persons can be purchased at the registration desk, SEK 150 per person.

Congress Dinner on Friday, September 14, 2012 at 19.30 The dinner will take place at Junibacken in a house of fantasy and play. You will experience the Story Train, which is a journey through the fabulous stories of Astrid Lindgren. A three course menu as well as an appetizer and drinks will be offered. Junibacken is situated on Djurgården in Stockholm, just behind Nordiska Museet in Galärparken, next door to the Vasa Museum. Tickets can be purchased at the registration desk, SEK 650. At 18.30, all attending the gala dinner at Junibacken will travel together. Meet at the main entrance of the Waterfront Congress Center.

11 GENERAL INFORMATION ABOUT STOCKHOLM Stockholm, one of the most beautiful capitals in the world, is built on 14 islands connected by 57 bridges. The beautiful buildings, the greenery, the fresh air and the proximity to the water are distinctive traits of this city. The Royal National City Park, (the first National City Park in the world), is a green space that breathes for the city, and a constant presence in the heart of the city.

With its 750 year history and rich cultural life, Stockholm offers a wide selection of world-class museums and attractions. Most of the city’s attractions can be reached on foot, and there’s a good chance of experiencing a lot of things in a short time. Experience big-city life, the history of civilization and natural scenery, all in the course of the same day.

Visit Stockholm City Hall. Climb the City Hall tower for a fantastic view of Stockholm. Don’t miss Gamla Stan, Stockholm’s oldest attraction and one of the best preserved medieval city centers in the world. Walk through small winding streets lined with stores full of handicrafts, antiques, art galleries and cafés. The Royal Palace and Stockholm Cathedral are also located in Gamla Stan.

The green island of Djurgården is home to some of the city’s most popular attractions. Visit the world-famous warship the Vasa, the world’s oldest open-air museum Skansen, or Astrid Lindgren’s Junibacken. And don’t miss the chance to see Stockholm from the water. Naturally a city built on fourteen islands offers marvelous views over the water. There are many different sightseeing tours to choose from. And if fourteen islands aren’t enough, Stockholm offers a wonderful archipelago with 30,000 islands, islet rocks and skerries.

12 VISIT STOCKHOLM

The Vasa Museum – From Wreck to state of the art! Address: Galärvarvsvägen 14, Djurgården, Stockholm Open: 08.30-18.00 daily www.vasamuseet.se/en

Discover Stockholm by boat! Welcome to our fantastic capital where city life meets nature and a lot of water. Stockholm offers a great variety of things to do and this site will help you find activities in Stockholm and the surrounding archipelago. www.stromma.se/en/stockholm

The Royal Palace of Stockholm Open: 15 May – 16 September: Daily 10.00–17.00 17 September – 14 May: Tues–Sun 12.00–16.00

Welcome to one of Europe’s largest and most dynamic palaces! The Royal Palace of Stockholm is His Majesty The King’s official residence and is also the setting for most of the monarchy’s official receptions. The palace is a daily place of work for The King and Queen as well as for the various departments that make up the Royal Court. This combination of royal residence, workplace and culture-historical monument open year round to visitors makes the Royal Palace of Stockholm unique amongst Europe’s royal residences.

13 The Old Town Stockholm was founded in the 13th century. The Old Town is the origin of Stockholm City and the Old Town constituted the main part of the city for several hundred years. The old town was for a long time the city in contrast to the more rural surroundings, Norrmalm, Södermalm and Östermalm (which are now also part of the city and heavily populated). There are now less than 3000 people living in the Old Town. Most of the buildings are from the 17th and 18th century. The Old Town has a large number of restaurants, tourist shops, art shops and museums. www.gamla-stan-stockholm.se/

Visit “Artipelag” Artipelag is a new and unique international venue where art exhibits, inspiring cultural activities, architecture, music, Swedish design and great dining live side by side with the beautiful archipelago environment. Travel by sea from Stockholm or Gustavsberg! Several ferry companies offer trips to Artipelag. The boat journey takes just over an hour and docks directly at Artipelag’s pier. www.artipelag.se/en/visit-artipelag

More activities, more attractions, more restaurants: www.visitstockholm.com/en/

14 Notes

15 Thursday Sept 13

A2, Main Lecture Hall, Level 6 C4, Lecture Room, Level 2

09.00-09.10 Opening and Welcome

Session 1 09.10-10.00 Children’s Orthopeadics

10.00-10.30 Coffee in the Exhibition Hall

Baumann Lecture 10.30-11.15 Carlo Frigo

Session 2a Session 2b 11.15-12.00 Imaging Methods Knee Osteoarthritis

12.00-13.00 Lunch and Coffee in the Exhibition Hall

Poster Session in the Exhibition Hall & Balcony 13.00-14.30 Neurology, Children, Orthotics

Keynote Lecture I 14.30-15.00 Tim Theologis

15.00-15.30 Coffee in the Exhibition Hall

Session 3a Session 3b 15.30 -17.00 Cerebral Palsy Descriptive Technical and Simulation

17.15 -19.00 ESMAC Annual General Meeting

19.00 User Group Meetings

16 17 THURSDAY, SEPTEMBER 13, 2012

09.00-09.10 WELCOME AND INTRODUCTION (A2)

09.10 - 10.00 SESSION 1 (A2) Children’s Orthopeadics Chairmen: Stephanie Böhm, Andreas Kranzl

O01 Stief, Felix Effect of intensive conservative therapy on gait performance in patients with Legg-Carvé- Perth-Disease

O02 Westhoff, Bettina Change of Gait pattern after Pelvic Osteotomy in children with Legg-Calve-Perthes Disease

O03 Boehm, Harald Predictors of compensatory and adaptive trunk movements during gait in children with Artho- gryposis Multiplex Congenita

O04 Engström, Pähr Botulinum toxin A does not improve cast treat- ment for idiopathic toe-walking- a prospective randomized trial

O05 Kranzl, Andreas Outcome of 23h Bracing for Tip-toe-walking Children with Cerebral Palsy

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10.30 - 11.15 BAUMANN LECTURE, Carlo Frigo, Assoc. Professor, PhD. Department of Bioengineering of Politecnico di Milano, Italy. Analysis and synthesis of human locomotion (A2)

Curriculum Vitae of Carlo Frigo Carlo Frigo has been working in the area of movement analysis and motor control since 1976, when he has graduated at Politecnico di Milano. His background is biomechanical engineering, although the group in which he has been involved is a multidisciplinary group, which includes electronics, informatics, automatics. His academic position is Associate Professor at the Faculty of System’s Engineering, and he belongs to the Department of Bioengineering of Politecnico di Milano. He has been working for 25 years in the Bioengineering Centre of Milan, that was an institutional coo- peration between Politecnico di Milano and Fondazione Don Gnocchi, one of the major rehabilitation and research institutes in Italy. In this frame he has been active part in the development of one of the renowned systems for movement analysis, the ELITE System.

He has also contributed to realize one of the first clinically oriented Gait Analysis laboratories: the SAFLo (Servizio di Analisi della Funzionalità Locomotoria). SAFLo is also the acronym of a gait analysis protocol that he has developed and that is now implemented in several gait analysis systems. Carlo Frigo has contributed to the con- stitution of the Italian Society for Clinical Movement Analysis (SIAMOC) of which he has been the first Secretary (years 1999-2003) and then President from 2007 to 2009. He has been active member of ESMAC, organizer of the 10th ESMAC congress in

24 Rome, 2001, held jointly with SIAMOC, and has been part of the ESMAC Committee. His present interests, beside clinical movement analysis and movement biomechanics, are musculoskeletal modelling, computer simulation, and all related applications in the field of orthotics and prosthetics, functional surgery, motor control and recovery of motion.

Abstract of this year’s Baumann lecture Analysis and Synthesis of human locomotion Analysis of human movement has evolved from early applications of technology, that were pioneered in the seventies/eighties of the last century, to current applications in which movement analysis is performed routinely in many clinical laboratories. Biome- chanical variables and neuromotor control have been investigated deeply since then, and useful information from the clinical point of view can now be obtained in individual subjects, and allow planning interventions and check the functional status of a patient.

More recently the possibility to model the musculoskeletal system and simulate hu- man movement has opened new perspectives to understanding the motor behaviour. Synthesis is the process of building a product by adding its constitutive components. Movement can be synthesized by properly combining input variables that control the degrees of freedom of a model. These variables can be joint angles and space coordi- nates, but also joint moments, muscle forces, environmental conditions. Integration of the two processes of analysis and synthesis can improve our capability to investigate complex mechanisms.

A typical problem we can face in this way is the ‘what if’ problem. The effects of changing muscle length and insertion points, changing the properties of muscle contraction, or patterns of muscle recruitment, for example, can all be investigated by this approach. In addition the function of muscles, in particular the double-joint ones, and the synergistic control of agonists and antagonists can be investigated in some specific conditions and better understood. It is foreseen that several aspects related to treatment of neuromotor disorders will be dramatically enhanced when models for simulating complex dynamic phenomena will be available with sufficient accuracy and ability to adapt to single individuals.

25 11.15 - 12.00 SESSION 2a (A2) Imaging methods Chairmen: Caroline Stewart, Reinald Brunner

O06 Sangeux, Morgan Do physical examination and CT-scan measures of femoral neck anteversion and tibial torsion relate to each other?

O07 van der Krogt, Subject-specific musculo-tendon parameters based on Marjolein MRI and dynamometer tests

O08 Passmore, Elyse Gait kinematics and radiographic deformity following Slipped Upper Femoral Epiphysis

O09 Weimann-Stahlschmidt, Correlation of radiological outcome and gait function Kristina of SCFE patients after growth arrest

11.15 - 12.00 SESSION 2b (C4) Knee Osteoarthritis Chairmen: Per Wretenberg, Josien van den Noort

O10 Scheys, Lennart Functional knee joint assymetry in subjects with Unilateral Knee Osteoarthritis: An analysis of 11 different motor tasks.

O11 Naili, Josefine 3D evaluation of the single limb mini squat test in patients with Knee Osteoarthritis

26 O12 Rätesepsoo, Monika Relationship between leg extensors strength, postural- stability and risk of falling in women with Gonathrosis after 2-months home exercise program

O13 Turcot, Katia Influence of knee alignment on gait in patients with Knee Osteoarthritis

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35

12 13 12:00 - 13:00 LUNCH IN THE EXHIBITION HALL

13.00 - 14.30 POSTER PRESENTATIONS IN EXHIBITION HALL & BALCONY

14:30 - 15:00 KEYNOTE SPEAKER I, Tim Theologis, MD, PhD, FRCS Nuffield Orthopaedic Centre, Oxford, UK Challenges in organizing surgical trials (A2)

Curriculum Vitae of Tim Theologis Tim Theologis studied medicine in Athens, Greece and completed his surgical and orthopaedic training in Oxford, UK. He also completed a paediatric orthopaedic fel- lowship at the Hospital for Sick Children in Toronto, Canada. In 1996 he was appointed at the Nuffield Orthopaedic Centre, a tertiary care hospital in Oxford, as a Consultant Orthopaedic Surgeon with special interest in children and neuromuscular disorders. He has developed a strong clinical and research link with the Oxford Gait Laboratory since.

He looks after children with orthopaedic conditions and musculoskeletal tumours, as well as neuromuscular disorders, including cerebral palsy. He is involved in the teach- ing of medical students, the supervision of postgraduate degrees and the training of orthopaedic residents. He has been involved in the ESMAC Committee activities since 2000 and was Chairman 2006-2010. He was appointed as Editor in Chief for Gait and Posture in 2005. The Oxford Gait Laboratory occupies a significant part of hisresearch and clinical activity.

36 Abstract Challenges in organising surgical trials Research in the field of gait analysis has led to improvements, both in the technology used and the reliability of the output available for clinical use. Scientific rigour on the part of engineers, scientists and clinicians involved in the motion analysis community has driven this field of research forward. As a result, scientific evidence supporting the reliability of gait analysis is now available and improvements have been introduced in the quality of clinical gait analysis. A recent randomized controlled trial (RCT) demonstrated that gait analysis results affect the clinicians’ decision-making in the management of children with cerebral palsy (CP).

Despite the improvements in the field of gait analysis, however, the evidence to support surgical interventions to improve gait in CP remains weak. Whilst prospective rando- mised controlled trials, often against placebo, are common in the pharmaceutical field, designing and undertaking surgical trials is particularly challenging. In the field of CP, some good quality RCTs supported the introduction of botulinum toxin treatment in the field. However, the evidence supporting single-stage multi-level surgery is weak, being supported only by one RCT and a relatively small number of case series studies. There are numerous challenges in organising surgical trials, particularly in the sensitive patient population with CP. Attracting funding for research in this field may be challen- ging as the patient population is relatively small. In comparison to other orthopaedic patient populations (e.g. hip fractures in the elderly, hip and knee osteoarthritis) the impact of the CP population on health services is relatively limited. Therefore, when applying for research funds, a convincing case has to be made of the impact of treating CP on health services and the potential increase of efficiency through effective and improved treatment.

Ethical issues are often challenging in this field. Children, families and ethical com- mittees have to be convinced that there is indeed true equipoise between two forms of surgical treatment or between an operation and conservative treatment. Surgical colleagues with established practices based on training and experience rather than evidence may also be difficult to persuade that a trial is necessary. Introducing new surgical techniques in this sensitive population may also cause ethical concerns. The practical difficulties in comparing surgical treatment against non-surgical manage- ment are obvious. Hiding surgical scars during the process and blinding assessors can be problematic, particularly during clinical examination but also in gait analysis. Placebo surgery has been used in some fields but most committees would probably consider it unethical in children with CP. Delaying surgical treatment for a pre-defined period of

37 time in a sub-group of patients has been suggested as a way to overcome this problem and form a control group. Defining the appropriate sample may also prove challenging. The main outcome of the trial has to be defined first and this may be controversial. The aims of the operation may include improvements in a variety of parameters, including objective gait measures, objectively measured motor function, patient perceived fun- ction, quality of life and body image. Once the main outcome is agreed, the minimum clinically important change has to be defined and calculated, if not available in the literature. The numbers that are usually necessary for an RCT are large. In most cases, it would take a single unit several years to recruit an adequate number of patients and retaining patients in the trial may also be problematic.

The length of follow-up necessary to establish the success of surgical treatment should be sufficient to allow full recovery. In the context of multilevel surgery this would translate into a minimum follow-up of two years. However, late recurrence of deformity and need for re-operation have been reported. Ideally, follow-up to skeletal maturity would, therefore, be necessary. For example, in order to establish that single- event multi-level surgery guided by gait analysis is the best option in correcting lower limb deformity to improve gait, a randomised controlled trial against surgery based on clinical assessment alone and against natural history would be necessary and follow- up should extend into adulthood. The difficulties of organising a trial of this scale are self-evident.

Well designed surgical trials are necessary in the field of CP. Scientific rigour similar to the one that led to the improvements in gait analysis would be necessary in desig- ning trials. However, a pragmatic approach is also necessary as ethical considerations, practical difficulties and recruitment problems represent significant challenges. Sup- port from professional bodies and patient/family groups can help put forward the need for such studies to the relevant funding bodies and drive this area of research forward.

38 15:00 - 15:30 COFFEE IN THE EXHIBITION HALL

15.30 - 17.00 SESSION 3a (A2) Cerebral Palsy Descriptive Chairmen: Malgorzata Syczewska, Elke Viehweger

O14 Klum, Elisa Predictors of excessive frontal plane trunk lean in adol- escents with cerebral palsy

O15 Bonikowski, Marcin Static proximal muscle shortening is present already in very young children with spastic bilateral CP

O16 Meyns, Pieter Neural control mechanism of forward and backward walking is preserved in children with Cerebral Palsy

O17 Gómez, David Relationship among gillette gait index parameters and GMFCS

O18 Löwing, Kristina Exploring relationships of the Gait Deviation Index and measures of body functions and activity in children with cerebral palsy, by using ICF as a framework

O19 Svehlik, Martin The growth and the development of gastro-soleus cont- racture in cerebral palsy

O20 Darras, Nikolaos Antagonist muscle strength development, of the lower extremities of ambulatory children with bilateral spastic cerebral palsy, in comparison to typically developing controls.

39 O21 Riad, Jacques Muscle strength and muscle volume in unilateral Cerebral Palsy

O22 Riad, Jacques Does muscle strength influence gait performance in unilateral Cerebral Palsy?

15.30-17.00 SESSION 3b (C4) Technical and Simulation Chairmen: Ilse Jonkers, Michael Schwartz

O23 Desaily, Eric Simulation of Muscle contracture in Cerebral Palsy (SiMusCP). Validation of a decision support system for hamstrings lengthening

O24 Kosterina, Natalia Force enhancement and force depression in a modified muscle model used for muscle activation prediction

O25 Wang, Ruoli Compensatory strategies for excessive muscle co-contraction at the ankle

O26 van der Krogt, A model of muscle spasticity in OpenSIM Marjolein

O27 Rozumalski, Adam Strictly Enforcing the Rigid Body Constraint Improves the Performance of a Functional Model Calibration Method: Results from a Mechanical Analog of the Leg

O28 Passmore, Elyse Improving repeatability of setting volume origin and coordinate system for 3D gait analysis

40 O29 Gantelius, Stefan Volumetric motion analysis - a simple and accurate way of measuring 3 dimensional reach in children

O30 Sangeux, Morgan Expert assessment of conventional and functional techniques to determine the knee axis

O31 van Hutten, Kim A tablet computer “app” for neuromusculoskeletal phy- sical examination in children with cerebral palsy

41 O14 2

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59

30 31 Notes

60 Friday Sept 14

A2, Main Lecture Hall, Level 6 C4, Lecture Room, Level 2

Session 4a Session 4b 09.00-10.00 Orthotics Adult Orthopeadics

10.00-10.30 Coffee in the Exhibition Hall

Session 5a Session 5b 10.30-12.00 Upper Extremity Foot

12.00-13.00 Lunch and Coffee in the Exhibition Hall

Poster Session in the Exhibition Hall & Balcony 13.00-14.30 Orthopeadics, Sports and Technical

Keynote Lecture II 14.30-15.00 Hans Forssberg

15.00-15.30 Coffee in the Exhibition Hall

Session 6a Session 6b 15.30 -17.00 Cerebral Palsy Effect Gait Assessment

19.30 Gala Dinner at Junibacken

61 Advanced EMG Systems MA-300

Five MA-300 EMG Systems to choose from! All Systems Include: • EMG Channels - 6, 8, 10, or 16 • Full Set of Preamplifiers • EMG Graphing Software • Minimum 10-1000Hz Bandwidth

Advanced Systems Also Include: • Custom Preamp Combinations • Bandwidth up to 2kHz • Additional 4 Research Channels • 8 Dedicated Events Channels • 8 Setting Low Pass Filter

“Motion Lab Systems provides our lab with more than just a good EMG system. They understand our special needs and challenges and go above and beyond to help.” Nicholas J. Gryfakis, M.S., Manager/Biomedical Engineer , Children’s Memorial Hospital , Chicago

System MA300-X Systems Advanced EMG Systems Comparison MA300-XII MA300-XVI MA300-18 MA-300-22 MA300-28 Total Channels 12 16 18 22 28 EMG/Multi-Use Channels 8 16 6 10 16 Extra Research Channels 4 0 4 4 4 Dedicated Event Channels 0 0 8 8 8 Package Included Standard System Package Enhanced EMG System Package EMG Bandwidth 10-1000 Hz -3dB 10-2000 Hz -3dB Variable Low Pass Filter No Yes- 8 Position LP Filter Included Preamplifier Options Gel Snap Preamplifier User Selected- Gel/Surface/ Fine Wire, Connector Material Plastic Binder Metal LEMO or Plastic Binder Options Software Included EMG Graphing Software Advanced EMG Analysis Software Backpack Support Adult Belt Adult and Child Sized Vests Event Switches Included No Yes

NEW WIRELESS OPTION: New and existing MA300 users can now easily and affordable upgrade to wireless! Plugs right in. Clean, real time data! www.motion-labs.com Baton Rouge, Louisiana, USA Email: [email protected] Ph: (225) 272-7364 Fax: (225) 272-7336

62

FRIDAY, SEPTEMBER 14, 2012

09.00 - 10.00 SESSION 4a (A2) Orthotics Chairmen: Richard Baker, Andrew Murphy

O32 Skaaret, Ingrid The impact of ankle-foot orthoses one year post ortho- paedic surgery in children with Cerebral Palsy

O33 Ries, Andy Do Ankle-Foot Orthoses Improve Gait for Individuals with Cerebral Palsy?

O34 Bartonek, Åsa Comparison of two carbon fibre spring orthosis on gait in children with Myelomeningocele

O35 Eriksson, Marie Oxygen cost during walking in children with Arthro- gryposis

O36 Block, Julia Sit to stand movement supported by an active orthosis

O37 Frechtel, Asaf Comparison of dynamic muscle activity and 3D gait kinematics acquired while wearing an electronic stance control orthosis versus a locked knee-ankle-foot orthosis: a case study

63

09.00-10.00 SESSION 4b (C4) Adult Orthopeadics Chairmen: Maria Grazia Benedetti, Han Houdijk

O38 Dickens, Wendy Lower limb kinematics following pelvic support osteo- tomy for unilateral avascular necrosis of the femoral head

O39 Meyer, Chistoper Early clinical gait analysis of patients following direct anterior approach total hip Arthoplasty: preliminary results

O40 Holsgaard-Larsen, Evaluating lower-limb asymmetry in ACL-patients: Anders assesment of jumping performance and mechanical muscle function

O41 Tengman, Eva One-leg hop - kinematic analysis ~20 years after anterior cruciate ligament injury.

O42 Barnett, Cleveland The role of the intact limb in the adaptation of transti- bial amputee obstacle crossing following rehabilitation

O43 Heitzmann, Danielle Gait strategies of transfemoral amputees descending slopes

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42 42 42 43 10.00 - 10.30 COFFEE IN THE EXHIBITION HALL

10.30 - 12.00 SESSION 5a (A2) Upper extremity Chairmen: Eva Pontén, Ellen Jaspers

O44 Assi, Ayman Kinematics of upper limbs in adults: database and repeatability study for anatomical and functional movements

O45 Barton, Gabor Correlation of the Movement Deviation Profile of shoulder muscle EMG with measures of shoulder function

O46 Bonnefoy-Mazure, Quantification of upper limb movements during gait Alice in Hereditary Spastic Paraplegia patients and Spastic Diplegia patients

O47 Lucareli, Paulo 3D quantitative analysis of upper limb movements by using weight bracelets in adults with dyskinetic Cerebral Palsy

O48 de Bruin, Marije Functional reach-to-grasp and muscle activation patterns before and after upper extremity surgery in patients with Cerebral Palsy

O49 van den Noort, Josien Reliability of 3D measurement of scapular kinematics with a wireless inertial and magnetic measurement system for clinical assessment of Scapular Dyskinesis: preliminary results

77 O50 De Baets, Liesbet Reliability of a three-dimensional bilateral scapular movement analysis in stroke patients

O51 Maier, Michael Can hemi shoulder arthroplasty restore the normal range of motion in activities of daily living in patients with degenerative osteoarthritis of the glenohumeral joint? A prospective 3D video motion analysis study.

O52 Evertsson, Björn The correlation between viscosity, elasticity and the cross-sectional area of wrist- and finger-flexor muscles – a Study of the NeuroFlexor®

10.30 - 12.00 SESSION 5b (C4) Foot Chairmen: Tim Theologis, Sebastian Wolff

O53 Stief, Felix A comparative evaluation of the aofas ankle-hindfoot scale and the foot function index using the Oxford foot model

O54 Boehm, Harald Effect of walking speed on foot kinematics determined by the Oxford Foot Model

O55 Adward Min Hyun, Definition of the Hindfoot Segment Axes in Oxford Paik Foot Model

O56 Hösl, Matthias Does excessive flatfoot deformity affect function? A comparison between symptomatic and asymptomatic pediatric flatfeet using the Oxford Foot Model

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He is a member of the Nobel Committee for Physiology and Medicine at KI, and chairman of the European Academy of Childhood Disability.   Forssberg has a broad scientific background with more than 200 publications in trans- ',6&866,21 &21&/86,216   )RUWKHG\QDPLFYDOLGDWLRQRIWKH)(PRGHOWKHORDGGXULQJRQHUHSUHVHQWDWLYHVWHSLQPLGVWDQFHZDVDSSOLHGRQWKH lational research on development of motor and cognitive control, as well as in clinical ',6&866,21 &21&/86,216 GXPP\PRGHO7KHUHVXOWVRIWKHGXPP\PRGHODQGWKH)(FDOFXODWLRQFRUUHODWHGZHOO2QO\WKHPRPHQWVLQ]GLUHFWLRQ research on neurodevelopmental disorders. )RUWKHG\QDPLFYDOLGDWLRQRIWKH)(PRGHOWKHORDGGXULQJRQHUHSUHVHQWDWLYHVWHSLQPLGVWDQFHZDVDSSOLHGRQWKH DWWKHDQNOHMRLQWGLIIHUHGEHWZHHQ)(0RGHODQGGXPP\PRGHO7KHUHDVRQLVQRWXQGHUVWRRG\HWDQGLVIXUWKHU GXPP\PRGHO7KHUHVXOWVRIWKHGXPP\PRGHODQGWKH)(FDOFXODWLRQFRUUHODWHGZHOO2QO\WKHPRPHQWVLQ]GLUHFWLRQ DQDO\]HG Abstract DWWKHDQNOHMRLQWGLIIHUHGEHWZHHQ)(0RGHODQGGXPP\PRGHO7KHUHDVRQLVQRWXQGHUVWRRG\HWDQGLVIXUWKHU  Development of fine motor control 5()(5(1&(6DQDO\]HG   *HIHQ$($%LRPHFKDQLFDO$QDO\VLVRIWKH7KUHH'LPHQVLRQDO)RRW6WUXFWXUH'XULQJ*DLW$%DVLF7RROIRU Most everyday activities require the manipulation of objects with the fingertips, an 5()(5(1&(6 &OLQLFDO$SSOLFDWLRQV7UDQVDFWLRQRI$60('HF± ability that is impaired in several neurodevelopmental disorders, e.g., CP and ADHD. *HIHQ$($%LRPHFKDQLFDO$QDO\VLVRIWKH7KUHH'LPHQVLRQDO)RRW6WUXFWXUH'XULQJ*DLW$%DVLF7RROIRU &KHXQJ-70=KDQJ0/HXQJ$./)DQ<%7KUHHGLPHQVLRQDOILQLWHHOHPHQWDQDO\VLVRIWKHIRRWGXULQJ &OLQLFDO$SSOLFDWLRQV7UDQVDFWLRQRI$60('HF± VWDQGLQJ²DPDWHULDOVHQVLWLYLW\VWXG\-RXUQDORI%LRPHFKDQLFV0D\  ± &KHXQJ-70=KDQJ0/HXQJ$./)DQ<%7KUHHGLPHQVLRQDOILQLWHHOHPHQWDQDO\VLVRIWKHIRRWGXULQJ VWDQGLQJ²DPDWHULDOVHQVLWLYLW\VWXG\-RXUQDORI%LRPHFKDQLFV0D\  ±

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61 Various factors have been identified that influence performance in manipulative tasks, such as strength, independent finger movements, finger speed, and the precise control of the fingertip forces employed to the object. We have investigated the development of motor control functions involved in object manipulation by means of behavioural and neuroimaging studies in typically developing children and children with neurode- velopmental disorders.

Recently we have focused on sensorimotor mechanisms involved in manipulation of unstable objects aiming at developing a clinical method to evaluate dexterity. This complex motor task is controlled by a striato-frontal-parietal-cerebellar network in which different parts seem to be designated to control specific motor functions, e.g., strength and dexterity.

15.30 - 17.00 SESSION 6a (C4) Cerebral Palsy Effect Chairmen: Per Åstrand, Kaat Desloovere

O62 Romei, Marianna Robotic assisted gait training and gait pattern in children affected with Cerebral Palsy

O63 Gantelius, Stefan Botulinum toxin injections in lower extremity changes activity in upper extremity in Cerebral Palsy-a case report

O64 Morais Filho, Cesar The impact of semitendinosus transfer at knee flexion deformity and crouch gait in patients with Cerebral Palsy

O65 Desailly, Eric Supervised classification of the effect of hamstrings lengthening in cerebral palsy children after single event multilevel surgery

99

O66 Vegvari, Dóra Proximal rectus femoris release does not influence the effects of distal rectus femoris transfer on the knee in Cerebral Palsy

O67 Lehtonen, Krista The impact of multilevel surgery on functional abilities and participation in adolescents with Cerebral Palsy (CP)

O68 Langerak, Nelleke Gait status of adults with bilateral spastic Cerebral Palsy more than 15 years after orthopaedic interventions

O69 Schwartz, Michael Identifying historical selection criteria for femoral derotational osteotomy using the random forest algorithm

O70 Schwartz, Michael Patterns of historical outcomes for femoral derotational osteotomy revealed by the random forest algorithm

15.30 - 17.00 SESSION 6b (C4) Gait assessment Chairmen: Julie Stebbins, Bertram Müller

O71 Brunner, Reinald The influence of muscle strength on kinematic gait deviations is similar across patients with various pathologies

O72 Esbjörnsson, The influence of walking speed on the gait deviation Anna-Clara index in individuals with Rheumatoid Arthritis

100 2

52%27,&$66,67('*$,775$,1,1*$1'*$,73$77(51,1&+,/'5(1 O73 Sloot, Lizeth Self-paced versus fixed speed in treadmill walking $))(&7(':,7+&(5(%5$/3$/6<  0DULDQQD5RPHL$EERQGDQ]D0RQWLQDUR/XLJL3LFFLQLQL&ULVWLQD0DJKLQLDQG$QQD&7XUFRQL  O74 Vardaxis, Vassilios Bilateral lower extremity stiffness during transition ,5&&6(0HGHD%LRHQJLQHHULQJ'HSDUWPHQW%RVLVLR3DULQL /& ,WDO\ ,5&&6(0HGHD)XQFWLRQDO5HKDELOLWDWLRQ'HSW%RVLVLR3DULQL /& ,WDO\ from stair descent to level walking in unilateral total  hip arthroplasty patients and controls ,1752'8&7,21 Improving and maintaining walking function is often a primary focus in the management of children with Cerebral Palsy (CP). Robotic assisted gait training (RAGT) is a rehabilitation strategy based on the principle 1 O75 Syczewska, Malgorzata Gait changes in patients after jaw and mandible that task-specific and repetitive practice is required to develop and improve a motor skill such as walking . 2,3 reconstruction with fibula and iliac crest bone and Previous studies reported improvement after RAGT in functional and motor abilities in children with soft tissue grafts acquired or congenital brain injury, but the effect of RAGT on gait pattern has not been yet assessed. The aim of this study was to evaluate through 3D Gait Analysis (3DGA) if adding paediatric RAGT to task-

oriented physiotherapy (TOP) in children with CP could improve gait pattern compared to intensive TOP.  O76 Lenaerts, Gerlinde Gait assymetry and trunk torsion in scoliotic girls 3$7,(1760$7(5,$/6DQG0(7+2'6 19 children with bilateral spastic CP, aged 4 to 16 years, were divided into two groups: the 9 children of RAGT+TOP group had 20 RAGT sessions and 20 TOP; the 10 children of ITOP group had 40 sessions of TOP. O77 Petrarca, Maurizio Gait deviations in patients operated on bladder RAGT was performed using the Lokomat (Hocoma Inc, Zurich, Switzerland), and during each RAGT session, extrophy the children walked for 30 minutes with body-weight support fixed at 50% for the entire duration of the training

and the leading force at 100%. The only parameter that was modified during the treatment sessions was the gait velocity, which was initially set at 1.2 km/h for all the children and was gradually increased to 1.6 km/h for O78 Franzén, Erica Cognitive and motor dual-tasking affects spatio- the youngest children and to 2.0 km/h for the oldest children. temporal gait characteristics in subjects with For standardization of TOP, a group of specific exercises for improving gait, balance and functional abilities, Parkinson’s disease strengthening extensor muscle and stretching of flexor muscle was chosen. Three clinical assessments were performed: pre (T0), post-treatment (T1) and 3 months after the end of treatment (T2). O79 Rozumalski, Adam Vertebral Motions of the Lumbar Spine During Gait As outcome measures gait velocity and Range Of Motion of lower limb joints (pelvic, hip and knee) on sagittal plane were calculated. For both the groups, the mean values for each parameter was calculated at T0, T1 and T2. In addition, for each child changes in outcomes were calculated by subtracting the value at T0 from the value obtained at T1 and at T2. Paired and unpaired T-Test was used to assess respectively within- and between groups differences (p<0.05).  5(68/76 Both the groups didnʼt significantly increase their gait speed or improve their ROM at lower limb joints after the training. No between groups differences were found after the training and three months after the training.  ',6&866,21 &21&/86,216 Compared to intensive TOP alone, the addition of RAGT to TOP didnʼt significantly change lower limb joint kinematic of children with CP and the gait pattern was maintained over time.  5()(5(1&(6 [1] Willoughby KL, et Al. Arch Phys Med Rehabil 2010; 91 (3): 333-339 [2] Meyer-Heim A, et Al. Arch Dis Child 2009; 94(8): 615-620 [3] Borggraefe I, et Al. Eur J Paed Neur 2010; 14(6): 496-502 101

62 O62 2

52%27,&$66,67('*$,775$,1,1*$1'*$,73$77(51,1&+,/'5(1 $))(&7(':,7+&(5(%5$/3$/6<  0DULDQQD5RPHL$EERQGDQ]D0RQWLQDUR/XLJL3LFFLQLQL&ULVWLQD0DJKLQLDQG$QQD&7XUFRQL  ,5&&6(0HGHD%LRHQJLQHHULQJ'HSDUWPHQW%RVLVLR3DULQL /& ,WDO\ ,5&&6(0HGHD)XQFWLRQDO5HKDELOLWDWLRQ'HSW%RVLVLR3DULQL /& ,WDO\  ,1752'8&7,21 Improving and maintaining walking function is often a primary focus in the management of children with Cerebral Palsy (CP). Robotic assisted gait training (RAGT) is a rehabilitation strategy based on the principle that task-specific and repetitive practice is required to develop and improve a motor skill such as walking 1. Previous studies2,3 reported improvement after RAGT in functional and motor abilities in children with acquired or congenital brain injury, but the effect of RAGT on gait pattern has not been yet assessed. The aim of this study was to evaluate through 3D Gait Analysis (3DGA) if adding paediatric RAGT to task- oriented physiotherapy (TOP) in children with CP could improve gait pattern compared to intensive TOP.  3$7,(1760$7(5,$/6DQG0(7+2'6 19 children with bilateral spastic CP, aged 4 to 16 years, were divided into two groups: the 9 children of RAGT+TOP group had 20 RAGT sessions and 20 TOP; the 10 children of ITOP group had 40 sessions of TOP. RAGT was performed using the Lokomat (Hocoma Inc, Zurich, Switzerland), and during each RAGT session, the children walked for 30 minutes with body-weight support fixed at 50% for the entire duration of the training and the leading force at 100%. The only parameter that was modified during the treatment sessions was the gait velocity, which was initially set at 1.2 km/h for all the children and was gradually increased to 1.6 km/h for the youngest children and to 2.0 km/h for the oldest children. For standardization of TOP, a group of specific exercises for improving gait, balance and functional abilities, strengthening extensor muscle and stretching of flexor muscle was chosen. Three clinical assessments were performed: pre (T0), post-treatment (T1) and 3 months after the end of treatment (T2). As outcome measures gait velocity and Range Of Motion of lower limb joints (pelvic, hip and knee) on sagittal plane were calculated. For both the groups, the mean values for each parameter was calculated at T0, T1 and T2. In addition, for each child changes in outcomes were calculated by subtracting the value at T0 from the value obtained at T1 and at T2. Paired and unpaired T-Test was used to assess respectively within- and between groups differences (p<0.05).  5(68/76 Both the groups didnʼt significantly increase their gait speed or improve their ROM at lower limb joints after the training. No between groups differences were found after the training and three months after the training.  ',6&866,21 &21&/86,216 Compared to intensive TOP alone, the addition of RAGT to TOP didnʼt significantly change lower limb joint kinematic of children with CP and the gait pattern was maintained over time.  5()(5(1&(6 [1] Willoughby KL, et Al. Arch Phys Med Rehabil 2010; 91 (3): 333-339 [2] Meyer-Heim A, et Al. Arch Dis Child 2009; 94(8): 615-620 [3] Borggraefe I, et Al. Eur J Paed Neur 2010; 14(6): 496-502 102

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119

79 Saturday Sept 15 A2, Main Lecture Hall, Level 6

Session 7 09.00-10.00 Balance and Posture

10.00-10.30 Coffee by Main Lecture Hall

Keynote Lecture III 10.30-11.15 Charlotte Häger

Session 8 11.15-12.00 Cerebral Palsy, Spasticity, Muscle and Gait

12.00-13.00 Awards and Closing

120 SATURDAY, SEPTEMBER 15, 2012

09.00 - 10.00 SESSION 7 (A2) Balance and Posture Chairmen: Bettina Westhoff, Kristina Löwing

O80 Houdijk, Han Stepping into an unstable environment: gait adapta- tions in response to medio-lateral balance perturba- tions.

O81 Romkes, Jacqueline Patients with diplegic cerebral palsy walking along a curved path

O82 Ballaz, Laurent Visually guided weight-shifting in children with Cerebral Palsy

O83 Lidbeck, Cecilia Crouched standing posture in bilateral cerebral palsy

O84 Stensdotter, Postural control in psychotic patients in quiet standing Ann-Katrin with a dual task

O85 Biabanimoghadam, Core and lower extremity muscle recruitment pattern Mana in response to an unexpected external perturbation in patients with Patellofemoral Pain Syndrome and healthy individuals

121 2 O80 2

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84 85 10.00 - 10.30 COFFEE by Main Lecture Hall

10.30 - 11.00 KEYNOTE SPEAKER III, Charlotte Häger, Profes- sor, RPT, Umeå University, Umeå, Sweden How may various movement laboratory techniques be used to increase the understanding of human sensorimotor control and address questions of clinical relevance? (A2)

Curriculum Vitae of Charlotte Häger Professor Häger is physiotherapist and professor at the Section of Physiotherapy, Umeå university, Sweden. Professor Häger obtained a PhD in neurophysiology in 1995. Her thesis was neuroscientific basic research in sensory physiology of direct importance for the understanding of human sensorimotor mechanisms related to the manipula- tive functions of the hand and the ability to reach and grasp for objects. She has since extended her research to include related clinical questions and projects involving also other types of sensorimotor tasks, like postural function in knee patients and neck function in patients with neck and back pain.

Studies particularly address pathophysiological issues and involve adult patients with neurological or musculoskeletal disorders as well as children with sensorimotor deficits, but also studies of the development of normal motor function in children of various ages. These latter studies serve as norms to be used as comparisons in diagno- sing and treating children with motor dysfunction.

128 Abstract How may various movement laboratory techniques be used to increase the understanding of human sensorimotor control and address questions of clinical relevance?

Sensorimotor control of human movement is complicated and difficult to study, especially in clinical conditions. The underlying mechanisms for certain movement behaviour are often unknown, and it may be difficult to identify which specific sensory input that drives the movement and what processes that determine the movement outcome whether it is going to be successful or not, an understanding that would seem essential in re-/habilitation. This lecture will describe research where various metho- dologies in movement laboratories are used to study human motor control and nerve- muscle function.

The research projects address basic understanding of human movement function as well as evaluation of clinical intervention with implications for rehabilitation and with regard to function of the upper as well as the lower extremity. The studies involve subjects with musculoskeletal conditions such as patellofemoral pain and anterior cruciate ligament injury, but also neurological diagnoses like spinal cord injury, stroke and cerebral palsy. Functional movement tasks examined include stair walking, balance tests and different jumps that are commonly used in the clinics for evaluation of knee rehabilitation for example after anterior cruciate ligament injury.

Other projects address hand and arm function in stroke patients, evaluated with detailed movement analysis, or evaluate training with interactive games in children with cerebral palsy. Intraneural microstimulation of single motor axons has been used to examine nerve-muscle function in subjects paralysed by cervical spinal cord injury (SCI). The results show that these methods help to capture pathological differences in movement patterns and leads to knowledge that increases the understanding of move- ment disorders and may guide treatment and rehabilitation.

The long term goal of the research is to improve the health of patients by building a better theoretical foundation for rehabilitation with particular emphasis on sensorimo- tor control.

129 11.00 - 12.30 SESSION 8 (A2) Cerebral Palsy Spasticity, Muscle, Gait Chairmen: Guy Molenaers, Meta N Eek

O86 Boulay, Christophe A new therapeutic target in equinus: Botulinum toxin injection (Dysport®) in Peroneus Longus

O87 Bar-On, Lynn Objective quantification of the effect of botulinum toxin-a injections in the medial hamstrings in children with spastic Cerebral Palsy

O88 Klotz, Matthias The influence of botulinum a toxin injections into gastrocsoleus on genu recurvatum in children with Spastic Diplegia

O89 Nyström Eek, Meta Muscle strength after BTX injection in children with Cerebral Palsy

130 O90 van Drongelen, Stefan The good and the bad one: gait-patterns in twins with Cerebral Palsy

O91 Dadashi, Farzin Multiscale entropy based features for spasticity diagnoses

O92 Desloovere, Kaat Comparison between different on- and offset detection methods for muscle activity during gait for children with Cerebral Palsy and typical developing children O93 Wambacq, Hans Probabilistic onset detection based on multiple strides

O94 Brunner, Reinald Increased femoral anteversion is not associated with internal hip rotation gait in Cerebral Palsy

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94 THURSDAY P1 Patricia Van de Walle 145 P3 David Gómez 146 P5 Davide Conte 147 P7 Philippe Dixon 148 P9 Maria Grazia Benedetti 149 P11 Ana De David 150 P13 Elzbieta Pretkiewicz-Abacjew 151 P15 Florian Kreuzpointner 152 P17 Jacqueline Romkes 153 P19 Christopher Newman 154 P21 Jefferson Cardoso 155 P23 Ana Presedo 156 P25 Maurizio Petrarca 157 P27 Hidehito Tomita 158 P29 Timothy Niiler 159 P31 Kadri Englas 160 P33 Etsuko Mori 161 P35 David Gómez 162 P37 Lynn Bar-On 163 P39 Daniela Biasotto Gonzalez 164 P41 Gordon Andi 165 P43 Katrien Fagard 166 P45 Marcin Bonikowski 167 P47 Catherine Huenaerts 168 P49 Patricia Van de Walle 169 P51 Leen Van Gestel 170 P53 Maurizio Petrarca 171 P55 Ellen Jaspers 172 P57 Thomas Dreher 173 P59 Lorena Llorente 174 P61 Diarmaid Fitzgerald 175 P63 Kwadwo Appiah-Kubi 176 P65 Susanne Lebek 177 P67 Tatsuo Kobayashi 178 P69 Yvette Kerkum 179 P71 Daniela Biasotto Gonzalez 180

141 P73 Neil Postans 181 P75 Marcin Bonikowski 182 P77 Thomas Dreher 183 P79 Alessandra Pacilli 184 P81 Marco Germanotta 185 P83 Gunilla Frykberg 186 P85 Gudrun Johansson 187 P87 Michael Smpiliris 188 P89 Jaap Buurke 189 P91 Jaap Buurke 190 P93 Sigal Portnoy 191 P95 Marc Nederhand 192 P97 Trienke IJmker 193 P99 Lea Awai 194 P101 Nikolaos Darras 195 P103 Daniela Biasotto Gonzalez 196 P105 Danielli Speciali 197

142 FRIDAY P2 Sjoerd Bruijn 198 P4 Zahra Rojhanishirazi 199 P6 Christian Wyss 200 P8 Oliver Rettig 201 P10 Christophe Meyer 202 P12 Zahra Rojhanishirazi 203 P14 Shavkat Kuchimov 204 P16 Benita Kuni 205 P18 Ambreen Chohan 206 P20 Mark Kasmer 207 P22 Loreen Pogrzeba 208 P24 Ellen Jaspers 209 P26 Maria Gomez 210 P28 Andrzej Mastalerz 211 P30 Alexandra Halvarsson 212 P32 Helena Grip 213 P34 Anna Trulsson 214 P36 Irene Rodríguez 215 P38 Silvestris Zebolds 216 P40 Helena Grip 217 P42 Yoshimasa Sagawa Jr 218 P44 Amir Al-Munajjed 219 P46 Thomas Dreher 220 P48 Marilynn Wyatt 221 P50 Nancy Thesing 222 P52 Christian Beyaert 223 P54 Ambreen Chohan 224 P56 Silvia Del Din 225 P58 Silvio Garbelotti Jr 226 P60 Małgorzata Ogurkowska 227 P62 Małgorzata Ogurkowska 228 P64 Jung Hwan Lee 229 P66 Ailish Malone 230 P68 Jung Hwan Lee 231 P70 Jo Røislien 232 P72 Christian Wyss 233

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Many training parameters 7KHUHDUHWKRXJKRWKHUSDUDPHWHUVRIPRYHPHQWOLNHPDLQWDLQLQJGLUHFWLRQ WXUQLQJDVZHOODVWKHDELOLW\WRPDLQWDLQ can be set, among which the percentage of body weight support, and the patient can perform passive or SDFHWKDWDUHQRWDGGUHVVHGE\JDLWDQDO\VLV9DULRXVVLPSOHWHVWVH[LVWIRUDVVHVVLQJLQGLYLGXDOSDUDPHWHUV7KHDLPRI active movement. The lower limb muscle activity during RAGT was investigated in adult subjects [3]. WKHSURMHFWZDVWRFUHDWHDQHZHDV\WRSHUIRUPJDLWODEWHVWWKDWXVHVWKHH[LVWLQJHTXLSPHQWWRDVVHVVREMHFWLYHO\WKHVH The aim of this case-study was to compare EMG activity of lower limb muscles in a 10-years old girl during H[WUDSDUDPHWHUV,WZDVFRQVLGHUHGWKDWWKLVLQIRUPDWLRQFDQEHYHU\XVHIXOIRUYDULRXVSDWKRORJLHVHVSHFLDOO\IRU RAGT according to different body weight supports and patientʼs passive/active movement. FRPSDULVRQVEHIRUHDQGDIWHUYDULRXVWUHDWPHQWV7KHLGHDZDVWRFUHDWHDVLPSOHSURWRFROWKDWFDQEHSHUIRUPHGIURP  3$7,(1760$7(5,$/6DQG0(7+2'6 VXEMHFWVZLWKGLIIHUHQWDELOLWLHVHYHQWKRVHWKDWXVHFRPPRGLWLHVOLNHFUXWFKHVUROODWRUVRUHYHQZKHHOFKDLU  DL is a ten years old girl affected with left hemiplegia due to vascular cerebral lesion, who had RAGT on 3$7,(1760$7(5,$/6DQG0(7+2'6 pediatric Lokomat (Hocoma, Zurich,CH). *DLWODE'PRWLRQDQDO\VLVV\VWHPLVXVHGWRUHFRUGWKHWUDMHFWRULHVRIWZRPDUNHUVWKDWDUHSODFHGRQWKHVXEMHFWV During RAGT, bilateral surface EMG activity of soleus (SOL), vastus medialis (VAM) and biceps femoris caput VKRXOGHUV DFURPLRQ $PGLVWDQFHDUHDLVGHILQHGLQWKHFHQWHURIWKHJDLWODEZDONZD\XVLQJFRQHV7KHVXEMHFWLV longus (BFCL) was recorded using FreeEMG (Bts, IT) at 1000Hz for at least 20 sec. Three training conditions WKHQDVNHGWRZDONIRUIXOOURXQGVDURXQGWKHFRQHVFORFNZLVH 7RWDO'LVWDQFH P DQGDIWHUDQLQWHUYDORIPLQ were tested: A) 100% of body weight (BW) supported by the Lokomat and passive movement; B) 100% of DQRWKHUIXOOURXQGVDQWLFORFNZLVH7KHLQVWUXFWLRQVDUHD NHHSDVWHDG\DQGFRPIRUWDEOHSDFHE VWD\FORVHWRWKH BW supported by Lokoma t and active movement, C) 20% of BW supported by Lokomat and active FRQHVDWDOOWLPHVDQGF WRSHUIRUPIXOOURXQGV7KHSURWRFROLVXVXDOO\UHSHDWHGWLPHVSHUGLUHFWLRQ%HIRUHVWDUWLQJ movement. URXQGVFORFNZLVHDQGDQWLFORFNZLVHDUHDOORZHGIRUSUDFWLFH7KHFROOHFWHG'FRRUGLQDWHVDUHWKHQSURFHVVHGWR  FUHDWHDYLUWXDOPDUNHUZKLFKLVORFDWHGLQWKHPLGGOHRIWKHGLVWDQFHRIWKHVKRXOGHUPDUNHUV7KH;<=WUDMHFWRULHVRI 5(68/76 WKHYLUWXDOPDUNHUDUHWKHQSURFHVVHGIRUFDOFXODWLQJDOOWKHSDUDPHWHUVIRUWKHDQDO\VLV7KHSDUDPHWHUVDQDO\]HGDUH During A condition there was EMG activity only on healthy limb muscles. When the patient was asked to 7RWDO;<WUDMHFWRU\OHQJWK/DS 6HPL/DS7UDMHFWRU\/HQJWK7RWDO7LPHDQG/DS 6HPL/DS7LPH0D[WUDMHFWRU\ perform active movement, EMG activity was present in sound and impaired limbs, both during fully BW YDOXHVLQ;D[LV VDJLWDO DQG<D[LV IURQWDO $QDOJRULWKPWKDWKDVEHHQGHYHORSHGGLYLGHVWKHWUDMHFWRULHVLQVWUDLJKW support and with 20% of BW support.  P DQG WXUQLQJ GLYLVLRQV   P  6WUDLJKW 7LPHDQG 7XUQLQJ 7LPH DV  RI WKH /DS 7LPHDUH DOVR  ',6&866,21 &21&/86,216 FDOFXODWHG3UHOLPLQDU\GDWDIURP0DOH )HPDOHDGXOWQRUPDOVXEMHFWDUHSUHVHQWHG7KHVXEMHFWVZHUHPHDVXUHG This case study showed that during RAGT EMG activity of impaired limb muscles was present only when the LQWZRGLIIHUHQWPRPHQWVRIWKHGD\IRUWZRGLIIHUHQWGD\VDZHHNDSDUW'HVFULSWLYHVWDWLVWLFVDQG&RHIILFLHQWVRI 9DULDWLRQ &9 DUHSUHVHQWHGIRUWKHSDUDPHWHUVPHDVXUHGIRUWKH0DOH 0 DQGWKH)HPDOH )  patient performed active movement and seemed increase when the BW Lokomat support was reduced. EMG  activity of sound limb muscles was present during passive movement too (SOL and BFCL) and seemed 5(68/76 increase during active movement passing from 100% BW to 20% BW of Lokomat support. These data 0HDQ7RWDO;<WUDMHFWRU\OHQJWK0 “P &9   ) “P0HDQ7RWDO7LPH0 “ suggest that during RAGT is important that the patient performs active movement in order to increase VHF &9   ) “VHF &9  0HDQ/DS7LPH0 “VHF &9   ) “ its muscles activity. VHF &9  0HDQP6WUDLJKW'LYLVLRQ7LPH0 “VHF &9   ) “VHF  &9  0HDQP7XUQLQJ'LYLVLRQ7LPH0 “VHF &9   ) “VHF 5()(5(1&(6 &9  6WUDLJKW'LYLVLRQ /DS7LPH 0 “ &9   ) “ &9  7XUQLQJ [1] Mayr et Al., Neurorehabil Neural Repair. 2007; 21: 307-14 'LYLVLRQ /DS7LPH 0 “ &9   ) “ &9   [2] Meyer-Heim et Al., Arch Dis Child 2009; 94:615-620  [3] Hidler JM, Wall AE. Clin Biomech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

97

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³$JODLD.\ULDNRX´&KLOGUHQ V+RVSLWDOQG2UWKRSDHGLF'HSW$WKHQV*UHHFH ,1752'8&7,21  ,1752'8&7,21 Robotic assisted gait training (RAGT) is a rehabilitation strategy that promotes the recovery of walking *DLWDQDO\VLVSURYLGHVFRPSUHKHQVLYHGRFXPHQWDWLRQRQWKHELRPHFKDQLFDOLVVXHVRIDSDWLHQWGXULQJOHYHOZDONLQJ following neurological gait disorders, both in adult and in pediatric population [1,2]. Many training parameters 7KHUHDUHWKRXJKRWKHUSDUDPHWHUVRIPRYHPHQWOLNHPDLQWDLQLQJGLUHFWLRQ WXUQLQJDVZHOODVWKHDELOLW\WRPDLQWDLQ can be set, among which the percentage of body weight support, and the patient can perform passive or SDFHWKDWDUHQRWDGGUHVVHGE\JDLWDQDO\VLV9DULRXVVLPSOHWHVWVH[LVWIRUDVVHVVLQJLQGLYLGXDOSDUDPHWHUV7KHDLPRI active movement. The lower limb muscle activity during RAGT was investigated in adult subjects [3]. WKHSURMHFWZDVWRFUHDWHDQHZHDV\WRSHUIRUPJDLWODEWHVWWKDWXVHVWKHH[LVWLQJHTXLSPHQWWRDVVHVVREMHFWLYHO\WKHVH The aim of this case-study was to compare EMG activity of lower limb muscles in a 10-years old girl during H[WUDSDUDPHWHUV,WZDVFRQVLGHUHGWKDWWKLVLQIRUPDWLRQFDQEHYHU\XVHIXOIRUYDULRXVSDWKRORJLHVHVSHFLDOO\IRU RAGT according to different body weight supports and patientʼs passive/active movement. FRPSDULVRQVEHIRUHDQGDIWHUYDULRXVWUHDWPHQWV7KHLGHDZDVWRFUHDWHDVLPSOHSURWRFROWKDWFDQEHSHUIRUPHGIURP  3$7,(1760$7(5,$/6DQG0(7+2'6 VXEMHFWVZLWKGLIIHUHQWDELOLWLHVHYHQWKRVHWKDWXVHFRPPRGLWLHVOLNHFUXWFKHVUROODWRUVRUHYHQZKHHOFKDLU  DL is a ten years old girl affected with left hemiplegia due to vascular cerebral lesion, who had RAGT on 3$7,(1760$7(5,$/6DQG0(7+2'6 pediatric Lokomat (Hocoma, Zurich,CH). *DLWODE'PRWLRQDQDO\VLVV\VWHPLVXVHGWRUHFRUGWKHWUDMHFWRULHVRIWZRPDUNHUVWKDWDUHSODFHGRQWKHVXEMHFWV During RAGT, bilateral surface EMG activity of soleus (SOL), vastus medialis (VAM) and biceps femoris caput VKRXOGHUV DFURPLRQ $PGLVWDQFHDUHDLVGHILQHGLQWKHFHQWHURIWKHJDLWODEZDONZD\XVLQJFRQHV7KHVXEMHFWLV longus (BFCL) was recorded using FreeEMG (Bts, IT) at 1000Hz for at least 20 sec. Three training conditions WKHQDVNHGWRZDONIRUIXOOURXQGVDURXQGWKHFRQHVFORFNZLVH 7RWDO'LVWDQFH P DQGDIWHUDQLQWHUYDORIPLQ were tested: A) 100% of body weight (BW) supported by the Lokomat and passive movement; B) 100% of DQRWKHUIXOOURXQGVDQWLFORFNZLVH7KHLQVWUXFWLRQVDUHD NHHSDVWHDG\DQGFRPIRUWDEOHSDFHE VWD\FORVHWRWKH BW supported by Lokoma t and active movement, C) 20% of BW supported by Lokomat and active FRQHVDWDOOWLPHVDQGF WRSHUIRUPIXOOURXQGV7KHSURWRFROLVXVXDOO\UHSHDWHGWLPHVSHUGLUHFWLRQ%HIRUHVWDUWLQJ movement. URXQGVFORFNZLVHDQGDQWLFORFNZLVHDUHDOORZHGIRUSUDFWLFH7KHFROOHFWHG'FRRUGLQDWHVDUHWKHQSURFHVVHGWR  FUHDWHDYLUWXDOPDUNHUZKLFKLVORFDWHGLQWKHPLGGOHRIWKHGLVWDQFHRIWKHVKRXOGHUPDUNHUV7KH;<=WUDMHFWRULHVRI 5(68/76 WKHYLUWXDOPDUNHUDUHWKHQSURFHVVHGIRUFDOFXODWLQJDOOWKHSDUDPHWHUVIRUWKHDQDO\VLV7KHSDUDPHWHUVDQDO\]HGDUH During A condition there was EMG activity only on healthy limb muscles. When the patient was asked to 7RWDO;<WUDMHFWRU\OHQJWK/DS 6HPL/DS7UDMHFWRU\/HQJWK7RWDO7LPHDQG/DS 6HPL/DS7LPH0D[WUDMHFWRU\ perform active movement, EMG activity was present in sound and impaired limbs, both during fully BW YDOXHVLQ;D[LV VDJLWDO DQG<D[LV IURQWDO $QDOJRULWKPWKDWKDVEHHQGHYHORSHGGLYLGHVWKHWUDMHFWRULHVLQVWUDLJKW support and with 20% of BW support.  P DQG WXUQLQJ GLYLVLRQV   P  6WUDLJKW 7LPHDQG 7XUQLQJ 7LPH DV  RI WKH /DS 7LPHDUH DOVR  ',6&866,21 &21&/86,216 FDOFXODWHG3UHOLPLQDU\GDWDIURP0DOH )HPDOHDGXOWQRUPDOVXEMHFWDUHSUHVHQWHG7KHVXEMHFWVZHUHPHDVXUHG This case study showed that during RAGT EMG activity of impaired limb muscles was present only when the LQWZRGLIIHUHQWPRPHQWVRIWKHGD\IRUWZRGLIIHUHQWGD\VDZHHNDSDUW'HVFULSWLYHVWDWLVWLFVDQG&RHIILFLHQWVRI 9DULDWLRQ &9 DUHSUHVHQWHGIRUWKHSDUDPHWHUVPHDVXUHGIRUWKH0DOH 0 DQGWKH)HPDOH )  patient performed active movement and seemed increase when the BW Lokomat support was reduced. EMG  activity of sound limb muscles was present during passive movement too (SOL and BFCL) and seemed 5(68/76 increase during active movement passing from 100% BW to 20% BW of Lokomat support. These data 0HDQ7RWDO;<WUDMHFWRU\OHQJWK0 “P &9   ) “P0HDQ7RWDO7LPH0 “ suggest that during RAGT is important that the patient performs active movement in order to increase VHF &9   ) “VHF &9  0HDQ/DS7LPH0 “VHF &9   ) “ its muscles activity. VHF &9  0HDQP6WUDLJKW'LYLVLRQ7LPH0 “VHF &9   ) “VHF  &9  0HDQP7XUQLQJ'LYLVLRQ7LPH0 “VHF &9   ) “VHF 5()(5(1&(6 &9  6WUDLJKW'LYLVLRQ /DS7LPH 0 “ &9   ) “ &9  7XUQLQJ [1] Mayr et Al., Neurorehabil Neural Repair. 2007; 21: 307-14 'LYLVLRQ /DS7LPH 0 “ &9   ) “ &9   [2] Meyer-Heim et Al., Arch Dis Child 2009; 94:615-620  [3] Hidler JM, Wall AE. Clin Biomech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

97

100 P98 Abstract preview ESMAC - Abstract submission Abstract preview ESMAC - Abstract submission

THE COMPARISON OF THE EFFECT OF MEDIAL LONGITUDINAL ARCH SUPPORT, THE EFFECT OF SUBTALAR HYPER PRONATION ON THE PELVIC ALIGNMENT HEEL & SOLE WEDGES ON THE PELVIC ALIGNMENT DURING STANCE PHASE OF DURING STANCE PHASE OF WALKING GAIT IN FLAT FOOTED SUBJECTS 1 1 1 1 1 Ali Ghanbari , Mohsen Razeghi , Farzaneh Yazdani , Samaneh Ebrahimi and Leila Abbasi 1 1 1 1 1 Mohsen Razeghi , Ali Ghanbari , Samaneh Ebrahimi , Farzaneh Yazdani and Elahe Shoara 1 Center of human motion sciences, School of Rehabilitation Sciences, Shiraz University of Medical Sciences, Shiraz, Iran 1Center of human motion sciences, School of Rehabilitation, Shiraz University of Medical Sciences, Shiraz, Iran INTRODUCTION INTRODUCTION Strong interactions exist between the segments of human body [1]. The pelvis, which is located in the center of the body, Excessive foot pronation, which is a serious anatomical abnormality, has been associated with low back pain due to has an important responsibility for connecting the upper body musculoskeletal system to the lower body; Thus, it may generating changes in the lumbopelvic alignment [1, 2]. Several researchers revealed the possibility of a relationship both affect and be affected by postural alterations of upper and lower segments, increasing the risk of low back pain [2]. between subtalar hyperpronation and shank, thigh, pelvis and lumbar malalignment. Therefore, excessive pronation may Previous studies have found that hyperpronation is highly prevalent [3]. The aim of this study was to examine the lead to several anatomical and functional problems in the lower extremity joints and segments [3]. Various types of relationship between subtalar hyperpronation and pelvic alignment during the stance phase of walking. orthotic devices have been introduced in order to unload the medial longitudinal arch and reduce the flat foot PATIENTS/MATERIALS and METHODS complications on the other joints. The purpose of this study was, therefore, to compare the pelvic alignment while 10 subjects with neutrally aligned feet and 10 with hyperpronated feet (rear foot angle ≥ 4) aged 23 ± 2.5 years were applying three different insole orthotics. selected after a complete lower extremity clinical examination. Retroreflective markers were placed on the body of ® subjects. The kinematic data were collected by a six camera motion capture system (Qualisys , Ltd., Sweden). Mean PATIENTS/MATERIALS and METHODS pelvic positions in the sagittal and frontal plane were calculated during the stance phase of walking. 10 female subjects (aged 19-25 years) with functional pes planus (rear foot angle ≥ 4) were investigated. Retroreflective markers were placed on the body of the subjects. The kinematic data were collected by a six camera motion capture RESULTS system (Qualisys®, Ltd., Sweden) while the subjects walked at a preferred speed in four different test situations: simple A significant higher amount of mean pelvic sagittal angle was found in the flat footed group compared to normal group insole (no correction), insole with medial arch support, insole with medial arch support and medial heel wedge, and (13.12°±1.72, 6.90°±1.98 respectively) (P<0.0001). Also the mean pelvic angle in frontal plane was statistically different insole with medial arch support and lateral fore foot wedge. in flat footed subjects in accordance to normal ones (3.64°±1.27, 2.37°±1.22 respectively) (P= 0.015). RESULTS DISCUSSION & CONCLUSIONS Applying a medial arch support with lateral wedge significantly reduced the pelvic angle in sagittal plane in comparison The pelvic alignments in both sagittal and frontal planes were different between the subjects with and without with simple insole(11.69°±1.67, 13.12°±1.72 respectively ) (P=0.005). However, the two other insoles did not affect this hyperpronation. This finding is in accordance with the study by Khamis and Yizhar [2]. The change in sagittal plane was angle (P>0.05). towards anterior pelvic tilt. The subtalar pronation generates a lower limb internal rotation at the hip joint, locating the DISCUSSION & CONCLUSIONS femoral head in a posterior position, which may lead to a posterior shift of the pelvis and trunk anterior deviation. So the Medial arch support with lateral forefoot wedge decreased the anterior pelvic tilt in flat footed subjects. This insole may anterior pelvic tilt occurs as a consequence. Also the calcaneal eversion causes a functional shortening of the lower limb reduce the functional foot malalignment by unloading the medial longitudinal arch and decreasing the hind foot pronation and therefore induces a pelvic lateral tilt toward the weight bearing limb [2]. and forefoot supination. However, the other orthotics did not significantly decrease the sagittal pelvic angle probably REFERENCES because they could not alter the alignment of foot sufficiently. It can be concluded that a medial arch support with lateral [1] Razeghi M, et al. (2000). Sports Med. 29:425-438. forefoot wedge has an immediate effect on reducing the anterior pelvic tilt. Therefore, it may minimize the possibility of

musculoskeletal injuries in flat footed subjects. [2] Khamis S, et al. (2007). Gait and posture. 25:127-134.

REFERENCES [3] Pinto R, et al. (2008) Manual Therapy. 13:513-519. [1] Khamis S, et al. (2007). Gait and posture. 25:127-134.

[2] Pinto R, et al. (2008). Manual Therapy. 13:513-519.

[3] Tiberio D, et al. (1988). Phys Therapy. 68:1840-1849.

246

1 1 P100 Abstract preview ESMAC - Abstract submission Abstract preview ESMAC - Abstract submission

THE COMPARISON OF THE EFFECT OF MEDIAL LONGITUDINAL ARCH SUPPORT, THE EFFECT OF SUBTALAR HYPER PRONATION ON THE PELVIC ALIGNMENT HEEL & SOLE WEDGES ON THE PELVIC ALIGNMENT DURING STANCE PHASE OF DURING STANCE PHASE OF WALKING GAIT IN FLAT FOOTED SUBJECTS 1 1 1 1 1 Ali Ghanbari , Mohsen Razeghi , Farzaneh Yazdani , Samaneh Ebrahimi and Leila Abbasi 1 1 1 1 1 Mohsen Razeghi , Ali Ghanbari , Samaneh Ebrahimi , Farzaneh Yazdani and Elahe Shoara 1 Center of human motion sciences, School of Rehabilitation Sciences, Shiraz University of Medical Sciences, Shiraz, Iran 1Center of human motion sciences, School of Rehabilitation, Shiraz University of Medical Sciences, Shiraz, Iran INTRODUCTION INTRODUCTION Strong interactions exist between the segments of human body [1]. The pelvis, which is located in the center of the body, Excessive foot pronation, which is a serious anatomical abnormality, has been associated with low back pain due to has an important responsibility for connecting the upper body musculoskeletal system to the lower body; Thus, it may generating changes in the lumbopelvic alignment [1, 2]. Several researchers revealed the possibility of a relationship both affect and be affected by postural alterations of upper and lower segments, increasing the risk of low back pain [2]. between subtalar hyperpronation and shank, thigh, pelvis and lumbar malalignment. Therefore, excessive pronation may Previous studies have found that hyperpronation is highly prevalent [3]. The aim of this study was to examine the lead to several anatomical and functional problems in the lower extremity joints and segments [3]. Various types of relationship between subtalar hyperpronation and pelvic alignment during the stance phase of walking. orthotic devices have been introduced in order to unload the medial longitudinal arch and reduce the flat foot PATIENTS/MATERIALS and METHODS complications on the other joints. The purpose of this study was, therefore, to compare the pelvic alignment while 10 subjects with neutrally aligned feet and 10 with hyperpronated feet (rear foot angle ≥ 4) aged 23 ± 2.5 years were applying three different insole orthotics. selected after a complete lower extremity clinical examination. Retroreflective markers were placed on the body of ® subjects. The kinematic data were collected by a six camera motion capture system (Qualisys , Ltd., Sweden). Mean PATIENTS/MATERIALS and METHODS pelvic positions in the sagittal and frontal plane were calculated during the stance phase of walking. 10 female subjects (aged 19-25 years) with functional pes planus (rear foot angle ≥ 4) were investigated. Retroreflective markers were placed on the body of the subjects. The kinematic data were collected by a six camera motion capture RESULTS system (Qualisys®, Ltd., Sweden) while the subjects walked at a preferred speed in four different test situations: simple A significant higher amount of mean pelvic sagittal angle was found in the flat footed group compared to normal group insole (no correction), insole with medial arch support, insole with medial arch support and medial heel wedge, and (13.12°±1.72, 6.90°±1.98 respectively) (P<0.0001). Also the mean pelvic angle in frontal plane was statistically different insole with medial arch support and lateral fore foot wedge. in flat footed subjects in accordance to normal ones (3.64°±1.27, 2.37°±1.22 respectively) (P= 0.015). RESULTS DISCUSSION & CONCLUSIONS Applying a medial arch support with lateral wedge significantly reduced the pelvic angle in sagittal plane in comparison The pelvic alignments in both sagittal and frontal planes were different between the subjects with and without with simple insole(11.69°±1.67, 13.12°±1.72 respectively ) (P=0.005). However, the two other insoles did not affect this hyperpronation. This finding is in accordance with the study by Khamis and Yizhar [2]. The change in sagittal plane was angle (P>0.05). towards anterior pelvic tilt. The subtalar pronation generates a lower limb internal rotation at the hip joint, locating the DISCUSSION & CONCLUSIONS femoral head in a posterior position, which may lead to a posterior shift of the pelvis and trunk anterior deviation. So the Medial arch support with lateral forefoot wedge decreased the anterior pelvic tilt in flat footed subjects. This insole may anterior pelvic tilt occurs as a consequence. Also the calcaneal eversion causes a functional shortening of the lower limb reduce the functional foot malalignment by unloading the medial longitudinal arch and decreasing the hind foot pronation and therefore induces a pelvic lateral tilt toward the weight bearing limb [2]. and forefoot supination. However, the other orthotics did not significantly decrease the sagittal pelvic angle probably REFERENCES because they could not alter the alignment of foot sufficiently. It can be concluded that a medial arch support with lateral [1] Razeghi M, et al. (2000). Sports Med. 29:425-438. forefoot wedge has an immediate effect on reducing the anterior pelvic tilt. Therefore, it may minimize the possibility of musculoskeletal injuries in flat footed subjects. [2] Khamis S, et al. (2007). Gait and posture. 25:127-134.

REFERENCES [3] Pinto R, et al. (2008) Manual Therapy. 13:513-519. [1] Khamis S, et al. (2007). Gait and posture. 25:127-134.

[2] Pinto R, et al. (2008). Manual Therapy. 13:513-519.

[3] Tiberio D, et al. (1988). Phys Therapy. 68:1840-1849.

247

1 1 Notes

248 249 Notes

250 251 INDEX OF AUTHORS

Aagaard, Per O40 Abbasi, Leila P100 Aertbeliën, Erwin O87, O92, O93, P37, P51, P55 Akalan, Ekin P14 Alanzi , Dhaher P63 Alimusaj, Merkur O43, P16 Alizadehkhaiyat, Omid O45 Al-Munajjed, Amir P44 Alvela, Mari P31 Aminian, Kamiar O91, P19 Amorin, Cesar P71, P103 Ananjeva, Tatjana P38 Andrade, Daniel P71 Aparecido, Graziela P71, P103 Appiah-Kubi, Kwadwo P63 Apti, Adnan O03, P14 Arabmotlagh, Mohammad O53 Armand, Stéphane O13 Artilheiro, Mariana O47 Askljung, Berit O89 Assi, Ayman O44 Athanatos, Lambros O59 Authier, Guillaume O86 Awai, Lea P99 Baird, Glen P41 Baker, Richard O30, P105 Balakumar, Jitendra O08 Ballaz, Laurent O82 Barbacena, Marcella P11 Barg, Alexej O94 Barnett, Cleveland O42 Bar-on, Lynn O26, O87, O92, O93, P24, P37, P47 Barton, Gabor O45 Bartonek, Åsa O04, O34, O35, O83 Bass, Alf O59 Bastiaensen, Annelies O92

252 Baten, Chris P89 Bates, Joanne O58 Batista Junior, João P21 Beek, Peter O80 Bell, Michael O38 Bellemans, J. O10, P80, P92 Benedetti, Maria Grazia P09 Beretta, Elena P94 Bernal, Milena P58 Berti, Lisa P09 Berzin, Fausto P71, P103 Beyaert, Christian P52 Biabanimoghadam, Mana O85 Biasotto-Gonzalez, Daniela P39, P71, P103 Billon-Grumillier, Constance P52 Block, Julia O36, O43, P08 Bolger, Ciaran P66 Bolliger, Marc P99 Bollini, Gérard O86 Bonikowski, Marcin O15, P45, P75 Bonnefoy-Mazure, Alice O46 Boulay, Christophe O86 Bourgeois, Aline O91, P19 Boviatsis, Efstathios P87 Braatz, Frank O43, O66, O88, P57, P77 Brabants, K. O10 Brégou Bourgeois, Aline P19 Brehm, Merel O31, P69 Brikisak, Victor P59 Brkic, Moamer O01 Broström, Eva W O11, O21, O22, O72, O83, P85 Bruijn, Sjoerd P02 Brunner, Reinald O61, O71, O94, P06, P17, P72, P77 Bruyninckx, Herman O93 Buizer, Annemieke P69 Bus, Sicco O48 Buurke, Jaap P89, P91, P95 Böhm, Harald O03, O14, O54, O56

253 Caione, Paolo O77 Callewaert, Barbara O10, P01, P80, P92 Capelli, Carlo P5 Cappa, Paolo P81 Carbone, Vincenzo O7 Cardoso, Jefferson P21, P105 Carniel, Sacha O77, P25, P53 Carraro, Elena P56 Carregaro, Rodrigo P21 Caskey, Paul P41 Castanier, Elisabeth O86 Castelli, Enrico O77, P27, P78, P79, P81 Cazaeck, Anne P37 Ceccato, Alessandro P5 Chabrol, Brigitte O86 Chen, Yi-Hua P84 Chohan , Ambreen P63 Cimolin, Veronica O47 Cinza, Aitor P35 Cobelli, Claudio P56, P88 Cockcroft, John O68 Colazza, Alessandra P53 Conradsson, David O78 Conte, Davide P05 Corbetta, Claudio P94 Correa, João O47, P105 Corten, Kristoff O39, P10 Cortesi, Matteo P88 Costa, Marcelo P21 Covill, Laura O74 Csepan, Robert O05 Curt, Armin P99 Czernuszenko, Anna O15, P45 Dadashi, Farzin O91 Darras, Nikolaos O20, P87, P96, P101 De Baets, Liesbet O50 De Bruin, Marije O48 De Cock, Paul P51

254 De Coulon, Geraldo O46 De David, Ana P11 De Rossi, Danillo P89 Dekker, Joost O49 Del Din, Silvia P56, P88 Delahunt, Eamonn P61 Delank, Karl-Stefan P65 Della Bella, Gessica O77 Delp, Scott O26 Dendorfer, Sebastian P90 Desailly, Eric O23, O65 Desloovere, Kaat O10, O16, O26, O39, O50, O87, O92, O93, P01, P10, P24, P37, P43, P47, P49, P51, P55, P80, P92 Dey, Paola P74 Dickens, Wendy O38 Dixon, Philippe P7 Djemal, Khalifa O65 Domizio, Suva O13 , P42 Donath, Susan O08 Dreher, Thomas O43, O51, O66, O88, O90, P46, P57, P77 Du Toit, Jacques O68 Dullien, Silvia P90 Duysens, Jacques O16, P02 Duysens, Jaak P51 Dykes, Daryll O79 Döderlein, Leonhard O03, O14, O54, O56 Ebert, Carsten O1 Ebrahimi, Samaneh P98, P100 Edström, Urban P40 Eek, Meta O89 Eelmae, Priit P31 Elmgren Frykberg, Gunilla P85 Englas, Kadri P31 Engström, Pähr O4 Ereline, Jaan O12 Eriksson, Marie O34, O35 Eriksson, Anders O24 Esbjörnsson, Anna-Clara O11, O72

255 Evertsson, Björn O52 Fabiano, Politti P71, P103 Facione, Julia P52 Fagard, Katrien P43 Fantozzi, Silvia P88 Fenner, Verena O14 Fernandes, James O38 Fewtrell, David P18 Feys, Hilde P51, P55 Fieggen, Graham O68 Fisher, Anthony O45 Fitzgerald, Diarmaid P61 Fosang, Adrienne O08, O30 Fosdahl, Merete O32 Franzén, Erika O78, P30 Frechtel, Asaf P93 Fritschy, Daniel O13 Frostick, Simon O45 Frykberg, Gunilla P31, P83, P85 Fujino, Marcelo O64 Fujita, Masanori P67 Fukagawa, S. P92 Fukaya, Yoshiki P27, P33 Fusaro, Isabella P9 Galli, Manuela O47 Gantelius, Stefan O29, O63 Gantz, Simone P77 Gapeyeva, Helena O12 Garbelotti Jr. Silvio P58 Garwicz, Martin P34 Gasior, Jakub O15, P45 Gasparre, Giuseppe P09 Gatta, Giorgio P88 Gatzonis, Stylianos P87 Georgi, Mathias P15 Germanotta, Marco P79, P81 Ghanbari, Ali P98, P100 Ghanem, Ismat O44

256 Glard, Yann O86 Gleeson, John P66 Godoy, Wagner P58 Gomes, Cid P39, P71, P103 Gomez, Maria P26 Gomez, Glenn O08 Gómez-Andrés, David P03, P35 Gonzalez, Tabajara P71, P103 González, Ignacio P36 González, Maria Teresa P36 Gordon, Andi P41 Gosselink, Rik P01 Grabiner, Mark P48 Graham, Kerr O06, O08 Grasl, Christian O05 Gravina, Aristide P56 Grecco, Luanda P39 Greve, Julia P58 Grifka, Joachim P90 Grill, Franz O05, O57 Grip, Helena O41, P32, P40, P83, P85 Grosz, Gabor O76 Grün, Markus O36 Guglielmin, Roberta P56 Gummesson, Christina P34 Gustavsson, Ola P34 Gutierrez-Farewik , Elena O04, O11, O18, O24, O25, O34, O29, O83 Gutteck, Natalia P65 Guzzetta, Andrea P51 Gwarek, Lucyna P28 Gäverth, Johan O52 Haas, Johannes-Peter P15 Habel, Rowan O30 Haefner, Renate P15 Hage, Yasmin P71, P103 Haglund-Åkerlind, Yvonne O04 Hagströmer, Maria O63 Hak, Laura O80

257 Hallemans, Ann P47 Halvarsson, Alexandra P30 Hans, Wambacq O92, O93, P01, P47 Hansson, Gert-Åke P34 Hareb, Farid O23 Harlaar, Jaap O26, O31, O49, O73, P69, P76 Hartmann, Matthias P15 Haviko, Tiit O12 Hawken, Malcolm O45 Hawkes, David O45 Heitzmann, Daniel O36, O43, O66, O88, P77, O90, P08, P57 Hekman, Karin O49 Herpich, Carolina P103 Heyrman, Lieve P55 Hickey, Claire P61 Himmelmann, Kate O89 Hoffmeyer , Pierre O13 Holm, Inger O32 Holmes, Gill O59 Holsgaard-Larsen, Anders O40 Hoppenot, Philippe O65 Houdijk, Han O65, O80, P97 Howard, Anthony O45 Huenaerts, Catherine O87, O92, P47, P01, Häger, Charlotte O41, P32, P40, P83, P85 Hösl, Matthias O14, O54, O56 IJmker, Trienke P97 Ilharreborde, Brice P23 Iversen, Maura O72 Iversholt, Tine O40 Jacquemier, Michel O86 James, Leroy O59 James, Selfe P18, P54 Jarbandhan, Ameerani P97 Jaspers, Ellen O50, P24, P55 Jensen, Carsten O40 Jim, Richards P18, P54, P74 Johansson, G P83, P85

258 Johansson, Gudrun P83, P85 Jonkers, Ilse O39, P10 Jorge, Luciana P39 Jouve, Jean-Luc O86 Jumtins, Andris P38 Jung, Bernhard P22 Jung, Ewy Ryoung P64 Kaelin, André O46 Kaida, Kenichi P67 Kalkum, Eva P16 Kanai, Akira P16, P33 Karam, Mohamad O44 Kasmer, Mark P20 Kasten, Philip O51 Kaufman, Kenton P48 Kawaguchi, Daisuke P33 Kawamura, Cátia O64 Kerkum, Yvette P69 Kerr, Catriona O60 Khouri, Néjib O23, O65 Kiernan, Damien P61 Kiis, Arne P44 Kim, Jin Sung O31, P64 Kingsbury, Trevor P48, P50 Kirwil, Monika O75 Klotz, Matthias O66, O88 Klum, Elisa O14 Kobayashi, Tatsuo P67 Koepp, Leah O74 Koopman, Bart O07 Kosterina, Natalia O24 Kostuj, Tanja O53 Krajewski, Krzysztof O75 Kranzl, Andreas O05, O57 Kraus, Tanja O19 Krauspe, Ruediger O02, O09 Krautwurst, Britta P57 Kreulen, Michiel O48

259 Kreuzpointner, Florian P15 Krummenauer, Frank O53 Kruus, Ulle P31 Kuchimov, Shavkat P14 Kuni, Benita P16 Labey, L. P80 Lamberts, Robert O68 Lamoth, Claudine P97 Langerak, Nelleke O68 Lavado, Edson P21 Leardini, A. P80 Lebek, Susanne P65 Lee, Jung Hwan P64, P68 Lee, Sang-Ho P64, P68 Lee, June Ho P64, P68 Lehtonen, Krista O67 Leistritz, Lutz O19 Leitch, Jessica O55 Lemay, Martin O82 Lenaerts, Gerlinde O76 Lennartsson, Anna O29 Lessl, Erich P46 Lewandowski, Jacek P60, P62 Liaño, Gabriel P35 Lidbeck, Cecilia O83 Lieske, Sebastian O53 Lin, Po-Chieh P84 Lindroos, Ola P86 Linhart, Wolfgang O19 Liu, Xue-cheng P20 Llorente, Lorena P59 Lofterod, Bjorn O32 Lopes, José Augusto O64 López, Javier O17, P03, P35 Lopez de Subijana, Cristina P26 Lorås, Håvard O84 Lubbeke-Wolf, Anne P42 Lucareli, Paulo O47, P21, P58, P105

260 Luft, Andreas P89 Luinge, Henk P89 Lundström, Ronnie P40, P86 Lübbeke, Anne O13 Löfgren, Niklas O78 Löwing, Kristina O18 MacWilliams, Bruce O27, O79 Maghini, Cristina O62 Mahoney, Craig O74 Maier, Michael O51, P77 Malone, Ailish P66 Mantoan, Alice P88 Marciano, Armando P77 Mariani, Benoit O91, P19 Martín, Juan Andrés O17, P03, P36 Martinet, Noël P52 Martín-Román, Lorena P35 Masiero, Stefano P56 Massaad, Firas P02 Massaad, Abir O44 Mastalerz, Andrzej P28 Mazda, Keyvan P23 Mazuquin, Bruno P21 McCahill, Jennifer O58 McMulkin, Mark P41 Megrot, Fabrice P23, P82 Meldrum, Dara P66 Mert, Agali O80 Mertens, P. O10 Meurer, Andrea O01, O53 Meyer, Christopher O39, P10 Meyns, Pieter O16, P51 Miller, Michael P34 Mindler, Gabriel O57 Molenaers, Guy O16, O47, O87, O92, P24, P37, P43, P49, P55 Monari, Davide O39, P24, P37, P43, P55 Montinaro, Abbondanza O62 Morais Filho, Mauro O64

261 Mori, Etsuko P33 Mortensen, Niels O40 Motealleh, Alireza O85 Mrozek, Patrycja P75 Multerer, Christel O03 Mussler, Johannes P16 Müller, Roman O36 Müller, Sebastian O46, P46 Mäenpää, Helena O67 Märtson, Aare O12 Naili, Josefine O11 Nassiri, Alex P86 Navarro, Enrique P26 Nederhand, Marc P95 Negishi, Daisuke O91 Nene, Anand P91, P95 Nestler, Falk O54 Nestoridis, Christos O20, P96, P101 Neto, Hugo P39 Nettrour, John O74 Neves, Daniella O64 Newman, Christopher O91, P19 Niemelä, Tuula O67 Niiler, Timothy P29 Nikhalat, Fatemeh P12 Niklasch, Mirjam O51 Nilsson, Kjell P40 Nixon, Mathew O59 Novacheck, Tom O69, O70, O79 Obara, Karen P21 O’Brien, Timothy P61 Ogurkowska, Malgorzata P60, P62 Oliveira, Claudia P39 Oliveira, Elaine P105 Op de Beeck, Nele P49 Opheim, Arve P70 Orefelt, Christina O04 Ortibus, Els P51

262 Out, Lia O31 Pacilli, Alessandra P79 Paik, Adward Min Hyun O55 Palermo, Eduardo P78 Palmen, Nina O02 Panian, Matti P65 Papavasiliou, Antigoni O20 Paradiso, Rita P89 Pascual-Pascual, Samuel Ignacio P35 Pasparakis, Dimitris O20, P96, P101 Passmore, Elyse O08, O28 Patanè, Fabrizio P25, P78 Patanè, Stefano P78 Paul, Starrs P18 Pavare, Zane P38 Pawlowski, Mariusz O15, P45 Payne, Katherine P54 Paysant, Jean P52 Penneçot, Georges P23, P82 Pentarakis, Manoussos O20, P96, P101 Pereira, Ligia P21 Petrarca, Maurizio O77, P25, P53, P78, P79, P81 Petrone, Nicola P05 Piccinini, Luigi O62, P94 Pigatto, Diego P05 Piirainen, Arja O67 Pintson, Margot P31 Pogrzeba, Loreen P22 Politti, Fabiano P71, P103 Polman, Remco O42 Pomero, Vincent O86 Pontén, Eva O29, O52, O63 Portnoy, Sigal O37, P93 Postans, Neil P73 Pratt, Emma O38 Presedo, Ana P23, P82 Pretkiewicz-Abacjew, Elzbieta P13 Pretto, Francesco P88

263 Pulido-Valdeolivas, Irene O17, P03, P35 Påhlman, Magnus O89 Pääsuke, Mati O12 Radler, Christof O57 Ramalho Jr. Amâncio P58 Rasmussen, John P44 Rausell Tamayo, Estrella O17 Raveh, Eitan O37, P92 Razeghi, Mohsen P98, P100 Reenalda, Jasper P89 Rehn, Börje P86 Reimeringer, Mikael O11 Renkawitz, Tobias P90 Rennie, Linda P70 Renzenbrink, Bertjo P91 Renzenbrink, Gerbert P95 Rettig, Oliver O51, P08 Reyes, Sergio P59 Riad, Jacques O21, O22, P29 Richards, Jim P18, P54, P74 Ries, Andrew O33 Rietman, Johan P91 Rigato, Alberto P88 Rijntjes, Daniëlle P97 Robert, Maxime O82 Roberts, Andrew P73 Robinson, Mark O45 Rodda, Jill O30 Rodríguez, Irene P36 Roebuck, Margaret O45 Rojhanishirazi, Zahra P04, P12 Romei, Marianna O62, P94 Romkes, Jacqueline O71, O81, P17 Rosenthal, Dietmar O02 Rossi, Stefano P25, P78, P79, P81 Rozumalski, Adam O27, O33, O69, O70, O72, O79 Ruhe, Katharina O09 Rutz, Erich O94

264 Rätsepsoo, Monika O12 Røislien, Jo P70 Saadat, Marzieh P04 Sadowski, Jerzy P28 Sagawa Jr, Yoshimasa P42 Sakas, Damianos P87 Sangeux, Morgan O06, O08, O28, O30 Sanpei, Ryosuke P67 Santos, Carlos O64 Sawacha, Zimi P56, P88 Sayadi, Saeed P103 Scheys, L. O10, P80, P92 Schmidmaier, Gerhard P46 Schmidt, Klaus O53 Schmitt, Holger P16 Schonhuth, Casper O49 Schroedl, Silvia P15 Schwartz, Isabella O37, P93 Schwartz, Michael O33, O27, O69, O70, O72, O79 Schweizer, Katrin O71, P17 Schwirtz, Ansgar P15 Scully, William P41 Sebsadji, Abdennour O23, O65 Selfe, James P18, P54 Selling, Jonas P83, P85 Seppet, Enn O12 Sessoms, Pinata P48 Seth, Ajay O26 Shim, Chan Sik P64 Shionoya, Katsuyoshi P27 Shoara, Elahe P98 Simon, Anne P23, P82 Simon, Jean Pierre O39, P10, Simons, Corien P89 Skaaret, Ingrid O32 Skalli, Wafa O44 Sloot, Lizeth O73, P76 Smeulders, Mark O48

265 Smiderle, Cristina P05 Smpiliris, Michael P87 Sokk, Jelena O12 Sousa, Dowglas P71, P103 Spamer, Marianne P15 Specialli, Danielli P105 Spolaor, Fabiola P56 Stathis, Pantelis P87 Stebbins, Julie O55, O58, O60, P07 Steele, Katherine O26 Steenbrink, Frans O80 Steinwender, Gerhard O19 Stenlund, Tobias P86 Stensdotter, Ann-Katrin O84 Stief, Felix O01, O53, Streich, Nikolaus P16 Sturdy, Jordan P48 Ståhle, Agneta O78, P30 Sunaert, Stefan P51 Sutton, Chris P74 Suvà, Domizio O13 Švehlík, Martin O19 Syczewska, Malgorzata O75 Szoke, George O76 Tedroff, Kristina O04 Temelli, Yener P44 Tengman, Eva P32, P41 Terebessy, Tamas O76 Theologis, Tim O58, O60, P07 Thesing, Nancy P48, P50 Thewlis, Dominic P74 Thews, Karin O18 Thomas, Stefan O94 Thomason, Pam O30 Tomita, Hidehito P27, P33 Tompkins, Brian P41 Totsuka, Kenji P27 Trulsson, Anna P34

266 Tsukahara, Yuri P27 Turconi, Anna O62, P94 Turcot, Katia O13, P42 Tziomaki, M. O30, P87, P96, P101 Tørholm, Søren P44 Unfried, Birgit P48 Unnermyr, Frans P86 Wacker, Markus P22 Walsh, Michael P61 Wambacq, Hans O92, O93, P01, P47 van Brempt, Jolien P01 van Campenhout , Anja O87 van De Poel, Nathalie P43 van de Walle, Patricia P01, P49, P55 van den Noort, Josien O49, P69 van der Krogt, Marjolein O07, O26, O73, P76 van der Wurf, Peter O80 van Deun, Sara O50 van Deursen, Robert P63 van Dieen, Jaap O80 van Drongelen, Stefan O36, O90 van Gestel, Leen O16, P02, P51 van Hutten, Kim O31 Vandendoorent, Britt O87 Vandenneucker, H. O10 Wang, Ruoli O24, O25, O34 Vanicek, Natalie O42 Wanvik, Anne Kristin O84 Vardaxis, Vassilios O74 Watanabe, Akiyoshi P33 Weber, Tim P44, P90 Veeger, DirkJan O48 Vegvari, Dóra O66, O76, P77 Weimann-Stahlschmidt, Kristina O09 Veltink, Peter P89 Verdonschot, Nico O07 Wervey, Roy O79 Wesseling, Mariska P10

267 Westhoff, Bettina O02, O09 Viehweger, Elke O86 Wiertsema, Suzanne O49 Viklund, Annika O63 Villard, Li O35 Willers, Reinhard O09 Vogt, Lutz O01 Wohlrab, David P65 Wolf, Sebastian O36, O43, O51, O66, O88, O90, P08, P16, P46, P57, P77 Volini, Silvia P09 Wyatt, Marilynn P48, P50 Wyss, Christian O61, P06, P72 Vänskä, Nea O67 Yamamoto, Yoshiji P27 Yang, Bing-Shiang P84 Yazdani, Farzaneh P98, P100 Yepremian, Daniel O23, O65 Zaccara, Antonio O77 Zambelli, Pierre-Yves P19 Zavatsky, Amy O55, P07, O60 Zebolds, Silvestris P38 Zeegers, Adelgunde P95 Zeifang, Felix O51 Zettersten, Kirsten O53 Zilkens, Christoph O02, O09 Zwick, Ernst O19 Öhberg, Fredrik P40, P86

268 COMMERCIAL EXHIBITION

Exhibition open hours Thursday, September 13th, 2012 08.00 – 19.00 Friday, September 14th, 2012 09.00 – 18.00

List of exhibitors AMTI AnyBody Technology Bertec Codamotion Cometa Contemplas Fior & Gentz Lion Systems Microgate Motek Medical Noraxon Novel Prophysics Qualisys RSscan International Simi Reality Motion Systems Tea mOl med Ultraflex Europe by Dirame Ortho Velamed Vicon

269 FLOORPLAN EXHIBITION HALL

ENTRANCE

ENTRANCE

BALCONY EXHIBITION- LEVEL HALL 4

(COFFEE & LUNCH)

P Posters 9 UltraflexEurope by Dirame Ortho 1 RSscan International 10 Motek Medical 2 Simi Reality Motion Systems 11 Contemplas | Prophysics 3 Velamed | Bertec | Microgate | Noraxon 12 Cometa Systems 4 Novel 13 Fior & Gentz 5 Vicon Motion Systems 14 Codamotion 6 TeamOlmed 15 AMTI 7 Anybody Technology 16 Qualisys 8 Lion Systems

270 FLOORPLAN STOCKHOLM WATERFRONT CONGRESS CENTRE

1

3

2

1 A2, Main Lecture Hall - LEVEL 6 2 C4, Lecture room - LEVEL 2 3 Exhibition hall - LEVEL 4 (Coffee & lunch)

271 AMTI AMTI has collaborated with top researchers to develop a wide range of force plates and instrumented biomechanics equipment. We offer many standard six-degree-of- freedom products and also regularly partner with individuals to create custom solu- tions for highly specialized applications.

Our standard products include mounted force plates, portable force plates, instrumen- ted treadmills, instrumented stairs, and instrumented walkers. We are also heavily in- volved in the field of biotribology, where our joint simulator machines are the industry standard for the evaluation of joint prosthetics.

AnyBody Technology AnyBody Technology provides software and consulting services for musculoskeletal analysis of daily activities. A validated full-body model with an unprecedented level of detail efficiently computes in-vivo kinematics and dynamic individual muscle and joint forces and many other properties of the musculoskeletal system. The body model is scalable and open allowing users to perform an automated optimized model fit to the subject to achieve maximum accuracy.

Spun-off from university research in 2002, the company employs a multinational team of experienced experts servicing customers in hundreds of organizations in Asia-Paci- fic, Europe, and the Americas.

272 Bertec ”Bertec Corporation is a global leading manufacturer of the most accurate force mea- suring instruments on the market today. Bertec makes force plates, load cells, instru- mented treadmills, custom transducers and balance plates used for research, rehabilita- tion and for sports applications”

CM Codamotion “The Codamotion system was designed from the beginning for use in clinical move- ment analysis applications, and this remains a primary use of the system. Codamotion sensor units are in operation in leading gait laboratories, hospitals, clinics and universities throughout the world.

Being portable, the Codamotion system can be used to provide mobile clinical services. A system can be up and running at a new location within minutes. The Codamotion system allows clinicians to quantify and interpret human locomo- tion. Clinicians can acquire full 3D bilateral movement data in real-time. Centres have the ability to analyse and document thousands of patient trials across normal and pathological populations. The system can be combined with force platforms and EMG systems to give kinetic analysis and muscle activity information. Video can also be used with high speed cameras.”

273 Cometasystems Designer and producer of the first wireless EMG systems, now with accelerometers, impedance check and up to 32 channels, Cometa is committed to provide the best technology for all budgets. Our systems are used and known worldwide for high signal fidelity and reliablity, thanks to our proprietary protocol of transmission. The longest battery life in the field, the smallest probes and the contactless recharge make them the most suitable systems to be integrated in your gait lab or to be used as a standalone EMG with our analysis software

Contemplas CONTEMPLAS GmbH, with its headquarter in Kempten/Germany, develops and distributes worldwide software solutions for gait, posture and general motion analysis in the medical and sports market.

The CONTEMPLAS motion analysis software TEMPLO offers the possibility to do analysis in different fields of applications, as Clinical Gait Analysis, 2D/3D Posture Analysis, Running Analysis, etc.

With the easy data acquisition and integration of other systems in the analysis process, such as EMG and pressure/force measuring systems, TEMPLO becomes an essential tool in the field of sport, medicine and science.

User- friendliness and dedicated analysis protocols based on the integration of the latest video technology help you while performing your analyses..

User- friendliness and dedicated analysis protocols based on the integration of the latest video technology help you while performing your analyses.

274 Dirame UltraflexEurope is a division of Dirame Ortho and is Ultraflex Systems USA´s Euro- pean, Middle East and African master distributor and education & clinical support centre. We provide Education, Supply of components, Central fabrication, Full service (we do everything from evaluation, casting, manufacturing, to final fitting.) Dirame is also exclusive importer and distributor for other international manufacurers. Ultraflex- Europe by Dirame, Assesteenweg 21-29, BE – 1740 Ternat (Brussels) – Belgium

Fior & Gentz FIOR & GENTZ, a limited liability company, was founded in Lueneburg, Germany (close to Hamburg) on March 1st, 1997 and dedicates itself to the development and sales of orthotic products. This includes therapeutic shoes for different indications as well as system components for the production of orthoses for paralysed patients. We would like to provide Orthotists/Prosthetists worldwide with techniques and products so that they can treat patients in an optimum way and at the highest level. Affected people can gain new mobility due to the latest technology. Further information you will find at www.fior-gentz.com.

275 Microgate North-Italian company founded in 1989, deals daily with high technology challen- ges: management systems for telescopes, professional timing devices and, last but not least, sport-performance/movement analysis systems. The company provides various solutions for biomechanical evaluation through optical sensors together with video cameras and photocells systems. www.microgate.it [email protected]

Motek Medical BV GRAIL is our latest innovative product: a complete solution not only for gait analysis, but also for gait re-training. All the parameters you traditionally find in gait reports, i.e. spatio-temporal parameters, kinematics, kinetics, are available in real-time. Deviations in gait can be identified on the fly or using an off-line gait analysis tool. Subsequently the deviating parameters can be modified using the functionality of the D-Flow software in a Virtual Environment with custom made applications. Real time gait adaptations can be accomplished by affecting a gait parameter using real-time feedback at a specifically selected period during the gait cycle.

276 Novel The company novel (Munich, Germany) brought pe- dography to medical science as a functional method of diagnosis of the foot. Founded in 1978, novel is distributing a complete system of foot analysis with the aid of pedography. This method has been scientifically tested worldwide. In only 8 minutes time, the physician or therapist is issued an analysis of the biomechanical function of both feet as an HTML file readable with any common browser. The procedure starts with the data collection from the novel database. For detailed information on all products offered by novel please visit www.novel.de.

Prophysics Prophysics, established in 1996, is a Switzerland-based company offering high-quality measurement equipment for the 2D and 3D analysis of motion as well as EMG and other biophysical signals. Working with industry leading companies such as Vicon, AMTI, Contemplas and Zebris, prophysics has established a strong user base and a reputation for excellent end-user support in German-speaking Europe. myon, also based in Switzerland, was established in 2008 to design and manufacture wireless measurement devices for EMG and other biophysical signals. In close cooperation with prophysics, a world-wide user base for the state-of-the-art myon 320 wireless EMG system has been established, offering customers ease of use, low latency and excellent synchronization. Together, myon and prophysics are pleased to offer clinical, sports, ergonomics and other users world-wide hardware and software solutions for EMG measurement and analysis. Additionally, prophysics continues to supply hardware and software for motion analysis as well as excellent pre- and post-sales support.

277 Qualisys Qualisys is a leading, global provider of products and services based on mocap. The core technology of Qualisys products has been developed in Sweden since 1989. The experienced Qualisys staff has created a unique platform for optical motion cap- ture, and Gait specialists all over the world rely on Qualisys' leading motion capture technology. The Project Automation Framework, PAF for QTM is a customizable infrastructure that lets you automate repetitive tasks in your workflow. Analyze a series of captures and create reports with the click of a button. Being fully customizable, PAF is the ultimate workflow tool for gait users.

Simi Reality Motion Systems Simi Reality Motion Systems GmbH offers a wide range of software and hardware for applications in the fields of sports science, physical education, medicine, industry, entertainment and behaviorism. It includes software and turnkey solutions for motion capture, automatic tracking, coaching, athlete feedback as well as motion analysis for scientific and educational purposes.

278 TeamOlmed TeamOlmed produce and provides patients with orthopedic devices. Products provi- ded include prosthetics, orthotics, corsets, shoes and insoles. Our company has 300 employees where our largest customers consist of several counties throughout Sweden. At our center for children in Solna our CPO’s and technicians have great experience in prescribing, developing and manufacturing orthopedic devices for children. For clinical analysis and evaluation of our products’ effect on our patients’ gait, we use a 2-dimensional motion analysis system. With close cooperation of parents, medical doctors, physical therapists and occupational therapist we commit to always fulfill the child’s needs seen from a complete perspective.

Velamed Velamed is a German company specialized in professional planning and implementa- tion of biomechanical labs. Velamed cooperates with the leading international manu- facturers in the area of biomechanics and sensor systems to meet the highest expecta- tions of its European academic and clinical customers. Velamed also works closely with its suppliers regarding the advancement and connectivity of the different systems. www.velamed.com [email protected]

279 Vicon Vicon delivers highly accurate 3D motion capture systems for use in gait analysis. Nearly 400 clinical gait labs world-wide use Vicon technology. Its flagship camera line, the Vicon T-Series, offers the highest resolution, frame rates and accuracy available, allowing detailed motion capture in almost any environment. Bonita is Vicon’s next generation camera, combining size, power, and price performance into one amazing solution. Vicon’s global clients include: University of Vienna; Nuffield Orthopaedic Centre; University of Brussels; Karolinska Institute; Guy’s and St Thomas’ Hospital; Katho- lieke Universiteit Leuven; Amsterdam Medical Centre; and Humboldt Universitat zu Berlin. For more information please visit www.vicon.com.

Lion Systems Lion Systems a Luxembourgish company specialized in developing and customizing high performance optical measuring systems based on innovative technologies. The research areas include clinical applications (dynamic foot scanner, foot motion ana- lysis, gait analysis systems) and industrial quality supervisions (solar panel, steel beam, artwork, engine inspection). Lion Systems also participates in several research projects in order to optimize their products and to develop new technologies. Main collabora- tors and customers are Adidas, ArcelorMittal, Delphi, Goodyear, Rehazenter, DFKI, Brussels University.

280 Noraxon USA, Inc. Noraxon USA provides market leading technology in measurement and training devi- ces, such as EMG, gait analysis, biofeedback and 2D/3D motion analysis that enables a unique approach to a fully equipped analysis and therapy concept for clinical and research applications. The leader in Human Performance Measurement Solutions for over 25 years! www.noraxon.com

RSscan International RSscan International offers professional solutions for highly accurate dynamic pres- sure measurements. This is done by use of our renowned footscan® systems. Our primary aim is to offer the costumer an affordable pressure measurement system with the best specifications to obtain an accurate result, combined with the clearest and easiest user interface in hardware and software. To reach these goals, our hard- and software developers use-state-of the-art techno- logy resulting in a high quality pressure measurement system for clinical, scientific and industrial use. We cooperate with several international universities, to validate the hard- and software parameters of the footscan® system.

281 Thursday Sept 13 Friday Sept 14 Saturday Sept 15

08.00-09.00 Registration

09.00-09.10 Opening & Welcome A2 Session 4a & 4b Session 7 Orthotics A2 Balance and Posture A2 Session 1 Adult Orthopeadics C4 09.10-10.00 Children’s Orthopeadics A2

10.00-10.30 Coffee & Exhibition Coffee & Exhibition Coffee

Keynote Lecture III A2 10.30-11.15 Baumann lecture A2 Session 5a & 5b Upper extremity A2 Session 2a & 2b Foot C4 Session 8 11.15-12.00 Imaging methods A2 Cerebral Palsy Spasticity, Muscle Knee Osteoarthritis C4 and Gait A2

12.00-13.00 Lunch & Exhibition Lunch & Exhibition Awards Closing A2

Poster presentations Poster presentations 13.00-14.30 Exhibition Hall & Balcony Exhibition Hall & Balcony

14.30-15.00 Keynote Lecture I A2 Keynote Lecture II A2

15.00-15.30 Coffee & Exhibition Coffee & Exhibition

Session 3a & 3b Session 6a & 6b 15.30-17.00 Cerebral Palsy Descriptive A2 Cerebral Palsy Effect A2 Technical and Simulation C4 Gait Assessment C4

17.15-19.00 ESMAC Annual General Meeting

19.00 User Group Meetings

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