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Review
. 2009 Aug;20(3):469-91.
doi: 10.1016/j.pmr.2009.04.005.

New clinical and research trends in lower extremity management for ambulatory children with cerebral palsy

Diane L Damiano  1 , Katharine E Alter, Henry Chambers
Affiliations
Review

New clinical and research trends in lower extremity management for ambulatory children with cerebral palsy

Diane L Damiano et al. Phys Med Rehabil Clin N Am. 2009 Aug.

Abstract

Cerebral palsy (CP) is the most prevalent physical disability in childhood and includes a group of disorders with varying manifestations. This article focuses on current and future intervention strategies for improving mobility and participation during the lifespan for ambulatory children with CP. The provision and integration of physical therapy and medical and orthopedic surgery management focused primarily on the lower extremities are discussed here. Some of the newer trends are more intense and task-related exercise strategies, greater precision in tone identification and management, and a shift towards musculoskeletal surgery that focuses more on promoting dynamic bony alignment and less on releasing or lengthening tendons. Advances in basic and clinical science and technology development are changing existing paradigms and offering renewed hope for improved functioning for children with CP who face a lifelong disability with unique challenges at each stage in life.

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Figures

Figure 1
Figure 1
Known or expected effects of specific neurotrasnmitters on neural structures or pathways. Epi =epinephrine, Nor-Epi= norepinepherine, SERT= serotonin, GABA= Gama-amino butyric Acid, GLUT= glutamate, GLY=glycerine Dopa = dopamine, SubP= substance P, Sensory/exeroceptive= sensory signals from outside CNS
Figure 2
Figure 2
TendoAchilles lengthening procedure showing the intact (A) and resutured (B) tendon
Figure 3
Figure 3
Gastrocsoleus recession procedure which only lengthens the uppermost gastrocnemius portion of the tendon
See this image and copyright information in PMC

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