A Program to Measure Walking Activity Pre & Post Surgery in Youth with Cerebral Palsy

Nancy Lennon MS, PT, Chris Church MPT, Rob Hulbert MS

Purpose: This tutorial will describe the development, implementation, and status of a program coordinated through the gait analysis laboratory to measure walking activity performance utilizing portable accelerometry.

Target Audience: Professionals interested in functional gait and mobility outcomes for children and youth with cerebral palsy.

Prerequisite Knowledge: Participants should understand the International Classification of Functioning Disability and Health (ICF) framework and its application to orthopedic care guided by gait analysis for youth with CP.

Summary: With the knowledge gained from this tutorial participants will develop skills in methods to measure and interpret walking activity for children and youth with cerebral palsy.

Motion Analysis Patient and Service Database (MAPS): An Update of New Features including Foot Model, Spine Model, Balance Testing,
Competency and Education

Adam Graf MS, Ross Chafetz, PT, DPT, PhD, MS, Rebecca Case MSPT, Christina Bickley, PhD

Purpose: The purpose of this tutorial is to describe an open source, publicly available database program created specifically for motion analysis laboratories. Motion Analysis Patients and Services (MAPS) is used for clinical, research and staff competency purposes and programmers are continuously adding new features. This tutorial will review MAPS base functions and describe its features that enhance lab productivity and performance.

Target Audience: Motion analysis center directors, managers, engineers, clinicians, and anyone interested in motion lab data management for clinical or research purposes.
Prerequisite

Prerequisite Knowledge: None

Summary: Motion Analysis Patients and Services (MAPS) is a comprehensive database designed to process motion data, generate reports, and facilitate staff competencies, research and education. MAPS was developed about 10 years ago at Shriners Hospitals for Children in Houston as a clinical tool, but has since evolved into a software program central to many aspects of a motion analysis Lab.

The outline of this tutorial is as follows:

1. Origin and history of MAPS
2. MAPS core functions – c3d file (marker, EMG and force plate data) processing to produce kinematics, kinetics and data plots.
3. MAPS as a documentation tool – medical history, questionnaires, surgeries, physical exams
4. MAPS new features – foot models, balance assessments, foot pressures
5. MAPS Spine Model
6. MAPS report generation for medical records
7. MAPS educational and staff competency tools

MAPS has now grown beyond a simple database for the typical gait evaluation. It has become a central component to many labs and has enabled collaborations by creating data outputs in compatible formats and sharing capabilities such as spine modeling.

Learning Objectives: At the completion of this tutorial, attendees will be able to:

1. Download and install MAPS for free
2. Describe the history and development of the MAPS database
3. Describe how MAPS processes movement data and create data plots
4. Describe how to use MAPS for competency and lab education
5. Discuss the possibilities of multicenter collaborations

Writing Effective Proposals and Fellowships for the National Institutes of Health

Andrew E. Anderson, PhD

Purpose: This tutorial will describe approaches to effectively writing NIH grant and fellowship proposals.
Target Audience: This tutorial is for conference attendees interested in submitting NIH grants/fellowships.
Prerequisite Knowledge: General working knowledge of the NIH system is recommended, but not strictly required.

Surface EMG in Clinical Practice: Collection, Processing and Interpretation

Sylvia Õunpuu MSc, Jean Stout PT, MS, Kristan Pierz MD, Tom
Novacheck MD and John Henley PhD

Purpose: To provide attendees with the knowledge needed to collect and interpret surface EMG data for clinical decision-making. This course will cover details from best practices in electrode placement and placement/signal validation to signal processing and presentation options. This will be followed by case examples of how EMG has been used to assist in treatment planning. The Course will end with a brief introduction into advanced EMG techniques. The focus will be on surface EMG techniques.

Target Audience: All personnel who are involved in the collection (application of electrodes and computer operation), processing and interpretation of EMG data for clinical decision making. This would include but is not limited to engineers, kinesiologists, physical therapists, biomechanists and physicians.

Prerequisite Knowledge: Participants should have the basic understanding of the role clinical gait analysis in treatment decision-making, familiarity with gait analysis output and terminology.

Summary: After this tutorial, participants will be able to:

1. Identify the EMG processing techniques (pros and cons) in clinical gait analysis
2. Describe the basics of best practices for EMG data collection
3. Explain the role of EMG in treatment decision-making for a variety of gait pathologies
4. Discuss advanced EMG analysis tools such as dynamic motor control, spasticity and fatigue

Roles of Distal Femoral Extension Osteotomy and Patellar Tendon Advancement in the Treatment of Severe Persistent Crouch Gait in Adolescents and Young Adults with Cerebral Palsy

Andy Georgiadis, MD, Liz Boyer, Ph.D., Tom Novacheck, MD, Jean Stout, PT, MS

Purpose: This course will discuss the principles, biomechanics, and treatment of crouch gait using distal femoral extension osteotomy and patellar tendon advancement (DFEO+PTA) in individuals with cerebral palsy. Case studies will be presented to highlight principles discussed. Short and long-term outcomes of treatment will also be addressed.
Target Audience: Pediatric orthopaedists, physiatrists, physical therapists, biomechanists and engineers who encounter children with cerebral palsy and crouch gait in their clinical practice.

Prerequisite Knowledge: Intermediate. Gait analysis interpretation skills are used.

Summary: This course will summarize our experience with DFEO+PTA as a treatment for severe crouch gait in individuals with cerebral palsy and will include these topics:

1. a definition and principles of crouch gait
2. new biomechanical insights
3. surgical techniques
4. complications
5. long- term functional and x-ray outcomes.

Comprehensive Foot and Ankle Assessment in a Motion Analysis Lab

Karen Kruger, Joseph Krzak, Adam Graf, Nancy Scullion, Bruce MacWilliams, Gerald Harris

Purpose: To provide a comprehensive review of current tools and methods to analyze foot and ankle pathology in a motion analysis lab. Methodologies presented will include current tools and emerging technologies.

Target Audience: Physicians, physical therapists, kinesiologists, biomechanists, motion lab engineers, researchers, and students interested in foot and ankle pathology.

Prerequisite Knowledge: Motion analysis fundamentals.

Summary: At the completion of this presentation, attendees will be able to:

1. Describe the characteristics of common foot and ankle pathologies
2. Describe common strategies for measuring foot and ankle dynamics
3. List common clinical examination tests and measures used to evaluate foot and ankle pathology