Annals of Physical and Rehabilitation Medicine, 2014
Introduction.-Children with cerebral palsy (CP) usually land their foot on the ground, flat or by... more Introduction.-Children with cerebral palsy (CP) usually land their foot on the ground, flat or by forefoot, in equinus when walking. The associated early braking of ankle dorsiflexion might be an adaptive function instead of being imposed by triceps surae dysfunction. Thus, wearing negative heel shoes (NHS), allowing in dorsiflexion flat landing and braking, would induce quick adaptation decreasing equinus at initial contact.
Annals of Physical and Rehabilitation Medicine, 2012
We present the case of a 54 year-old man presenting with a right Brown-Séquard plus syndrome (BSP... more We present the case of a 54 year-old man presenting with a right Brown-Séquard plus syndrome (BSPS) after a traumatic cervical spinal cord injury. After being operated on with selective tibial neurotomy and triceps surae lengthening because of a right spastic equinus foot, he developed a gait disorder at high speed. The patient complained about an instability of the right knee. Observational gait analysis exhibited an oscillating, flexion/extension motion of the right knee during stance, which was confirmed by gait analysis. Dynamic electromyographic recordings exhibited a clonus of the right rectus femoris (RF) during stance. The spastic activity of the RF and the abnormal knee motion totally reversed after a motor nerve block of the RF, as well as after botulinum toxin type A injection into the RF. We emphasize that complex, spastic gait disorders can benefit from a comprehensive assessment including gait analysis and nerve blocks. #
Annals of Physical and Rehabilitation Medicine, 2012
Résultats.-La différence moyenne entre les mesures en CT-Scan et EOS était entre 1,978 et 2,468 (... more Résultats.-La différence moyenne entre les mesures en CT-Scan et EOS était entre 1,978 et 2,468 (non significatif). Les deux séries de mesures présentaient une excellente corrélation (r = 0,92). Les reproductibilités intra et interobservateur pour la mesure EOS étaient excellentes (ICC = 0,98, SEM = 6,728 et ICC = 0,98, SEM = 6,888, respectivement). En situation d'antéversion modifiée les deux méthodes différaient de 1,188 à 2,348 (non significatif). Discussion.-Ces premières données métrologiques in vitro, nécessaires du fait de la double irradiation, montre la validité et la fiabilité du système EOS pour la mesure de l'antéversion fémorale physiologique et pathologique. Une étude invivo devra confirmer les limites d'agréments de cette mesure sur la population des personnes atteint de paralysie cérébrale.
Annals of Physical and Rehabilitation Medicine, 2012
Results.-Collected data showed big variety of lower limb rotational deformities, are multilevel l... more Results.-Collected data showed big variety of lower limb rotational deformities, are multilevel localised in same direction or, more frequently, in opposite directions. Nevertheless, more frequent patterns were identifying. Foot progression angle is internal in 61% of the case, neutral in 18% of the cases and external in 21% of the cases. Pelvic rotation is internal in 41% of the cases, neutral in 32% of the cases and external in 27% of the cases. Hip rotation is internal in 29% of the cases, neutral in 44% of the cases and external in 27% of the cases. Ankle rotation is internal in 55% of the cases, neutral in 29% of the cases and external in 16% of the cases. Discussion.-Lower limb rotational troubles are often localised on many levels and are in opposite directions for 46% of the cases. Pelvic rotational troubles as single cause of abnormal foot progression angle represents 17% of the cases and cannot be revealed by physical examination. The ignorance of it can lead to inadequate therapeutic decision. Internal ankle rotation represents 29% of single cause of abnormal foot progression angle. The study could not revealed a classification as in sagittal plane. Big variety of associated lower limb torsional troubles by a same CP child need kinematic for identification of all troubles. Three-dimensional gait analysis data associated with physical examination is essential to find causes of lower limb rotational troubles (torsional bone deformity, muscles spasticity, muscles contracture).
Annals of Physical and Rehabilitation Medicine, 2013
Introduction.-Lack of hip extension due to psoas contracture in ambulatory spastic diplegic child... more Introduction.-Lack of hip extension due to psoas contracture in ambulatory spastic diplegic children with cerebral palsy is frequent and impedes forward progression. The aim of the study was to evaluate psoas tenotomy outcomes on hip range of motion and on deambulation. Materials and methods.-Twelve children with spastic cerebral palsy, GMFCS II and III, were retrospectively reviewed. Each child had a psoas tenotomy during a single event multi-level surgery between 2005 and 2008; nine had a bilateral procedure. The mean follow-up was 3.4 + 0.55 years. Data collected in pre-and in post-operative were hip range of motion on physical examination and on 3D-gait analysis data: maximal hip extension, pelvic obliquity range of motion, gait velocity, step length and Gillette Gait Index (GGI). The Wilcoxon Test was used for statistical analysis.
Annals of Physical and Rehabilitation Medicine, 2014
Introduction.-Children with cerebral palsy (CP) usually land their foot on the ground, flat or by... more Introduction.-Children with cerebral palsy (CP) usually land their foot on the ground, flat or by forefoot, in equinus when walking. The associated early braking of ankle dorsiflexion might be an adaptive function instead of being imposed by triceps surae dysfunction. Thus, wearing negative heel shoes (NHS), allowing in dorsiflexion flat landing and braking, would induce quick adaptation decreasing equinus at initial contact.
Annals of Physical and Rehabilitation Medicine, 2012
We present the case of a 54 year-old man presenting with a right Brown-Séquard plus syndrome (BSP... more We present the case of a 54 year-old man presenting with a right Brown-Séquard plus syndrome (BSPS) after a traumatic cervical spinal cord injury. After being operated on with selective tibial neurotomy and triceps surae lengthening because of a right spastic equinus foot, he developed a gait disorder at high speed. The patient complained about an instability of the right knee. Observational gait analysis exhibited an oscillating, flexion/extension motion of the right knee during stance, which was confirmed by gait analysis. Dynamic electromyographic recordings exhibited a clonus of the right rectus femoris (RF) during stance. The spastic activity of the RF and the abnormal knee motion totally reversed after a motor nerve block of the RF, as well as after botulinum toxin type A injection into the RF. We emphasize that complex, spastic gait disorders can benefit from a comprehensive assessment including gait analysis and nerve blocks. #
Annals of Physical and Rehabilitation Medicine, 2012
Résultats.-La différence moyenne entre les mesures en CT-Scan et EOS était entre 1,978 et 2,468 (... more Résultats.-La différence moyenne entre les mesures en CT-Scan et EOS était entre 1,978 et 2,468 (non significatif). Les deux séries de mesures présentaient une excellente corrélation (r = 0,92). Les reproductibilités intra et interobservateur pour la mesure EOS étaient excellentes (ICC = 0,98, SEM = 6,728 et ICC = 0,98, SEM = 6,888, respectivement). En situation d'antéversion modifiée les deux méthodes différaient de 1,188 à 2,348 (non significatif). Discussion.-Ces premières données métrologiques in vitro, nécessaires du fait de la double irradiation, montre la validité et la fiabilité du système EOS pour la mesure de l'antéversion fémorale physiologique et pathologique. Une étude invivo devra confirmer les limites d'agréments de cette mesure sur la population des personnes atteint de paralysie cérébrale.
Annals of Physical and Rehabilitation Medicine, 2012
Results.-Collected data showed big variety of lower limb rotational deformities, are multilevel l... more Results.-Collected data showed big variety of lower limb rotational deformities, are multilevel localised in same direction or, more frequently, in opposite directions. Nevertheless, more frequent patterns were identifying. Foot progression angle is internal in 61% of the case, neutral in 18% of the cases and external in 21% of the cases. Pelvic rotation is internal in 41% of the cases, neutral in 32% of the cases and external in 27% of the cases. Hip rotation is internal in 29% of the cases, neutral in 44% of the cases and external in 27% of the cases. Ankle rotation is internal in 55% of the cases, neutral in 29% of the cases and external in 16% of the cases. Discussion.-Lower limb rotational troubles are often localised on many levels and are in opposite directions for 46% of the cases. Pelvic rotational troubles as single cause of abnormal foot progression angle represents 17% of the cases and cannot be revealed by physical examination. The ignorance of it can lead to inadequate therapeutic decision. Internal ankle rotation represents 29% of single cause of abnormal foot progression angle. The study could not revealed a classification as in sagittal plane. Big variety of associated lower limb torsional troubles by a same CP child need kinematic for identification of all troubles. Three-dimensional gait analysis data associated with physical examination is essential to find causes of lower limb rotational troubles (torsional bone deformity, muscles spasticity, muscles contracture).
Annals of Physical and Rehabilitation Medicine, 2013
Introduction.-Lack of hip extension due to psoas contracture in ambulatory spastic diplegic child... more Introduction.-Lack of hip extension due to psoas contracture in ambulatory spastic diplegic children with cerebral palsy is frequent and impedes forward progression. The aim of the study was to evaluate psoas tenotomy outcomes on hip range of motion and on deambulation. Materials and methods.-Twelve children with spastic cerebral palsy, GMFCS II and III, were retrospectively reviewed. Each child had a psoas tenotomy during a single event multi-level surgery between 2005 and 2008; nine had a bilateral procedure. The mean follow-up was 3.4 + 0.55 years. Data collected in pre-and in post-operative were hip range of motion on physical examination and on 3D-gait analysis data: maximal hip extension, pelvic obliquity range of motion, gait velocity, step length and Gillette Gait Index (GGI). The Wilcoxon Test was used for statistical analysis.
Uploads
Papers by Rémy Gross