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Selected Instructional Course Lecture   |    
Optimization of Walking Ability of Children with Cerebral Palsy
Jon R. Davids, MD1; Sylvia Õunpuu, MS2; Peter A. DeLuca, MD2; Roy B. Davis, III, P1
1 Motion Analysis Laboratory, Shriners Hospital for Children, 950 West Faris Road, Greenville, SC 29605. E-mail address for J.R. Davids: jdavids@shrinenet.org
2 Center for Motion Analysis, Connecticut Children's Medical Center, 282 Washington Street, Hartford, CT 06106
View Disclosures and Other Information
The authors did not receive grants or outside funding in support of their research or preparation of this manuscript. They did not receive payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, educational institution, or other charitable or nonprofit organization with which the authors are affiliated or associated.
Printed with permission of the American Academy of Orthopaedic Surgeons. This article, as well as other lectures presented at the Academy's Annual Meeting, will be available in March 2004 in Instructional Course Lectures, Volume 53. The complete volume can be ordered online at www.aaos.org, or by calling 800-626-6726 (8 a.m.-5 p.m., Central time).
An Instructional Course Lecture, American Academy of Orthopaedic Surgeons

The Journal of Bone and Joint Surgery, Incorporated
J Bone Joint Surg Am, 2003 Nov 01;85(11):2224-2234
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Extract

In the last fifteen years, a new paradigm has emerged for orthopaedic clinical decision-making to optimize the walking ability of children with cerebral palsy. This paradigm is based on the biomechanics of normal gait, pathologic gait, and gait disruptions associated with distinct clinical disease processes as well as on a greater understanding of the anatomy and physiology of the muscle-tendon unit and the importance of skeletal alignment1.Normal gait has been studied, and with current technology we are now able to quantitatively measure the normal movements associated with gait (kinematics) and to objectively assess the principal applied moments acting about the joints (kinetics) during the gait cycle1,2. This information, coupled with the electrical potentials generated by individual muscles during the gait cycle (dynamic electromyography), has documented the maturation of normal gait in children and led to the development of agematched normal profiles for walking3.
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    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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