motor function pelvic parameters in walking or … between gmfcs and pelvic parameters ( pelvic...

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Dr J‐C. Bernard, J. Deceuninck, E. Loustalet, E. Morel, A. Combey, J. Sutton, E. Berthonnaud, Dr E. Chaléat‐Valayer. Centre Médico‐Chirurgical des Massues.Croix‐Rouge française. bernard‐mpr@cmcr‐massues.com Sagittal X‐ray parameters in walking or ambulating children with cerebral palsy. Annals of Physical and Rehabilitation Medicine. 2013 ; 56 (2) : 123‐133. Motor function levels and pelvic parameters in walking or ambulating cerebral palsy children

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Page 1: Motor function pelvic parameters in walking or … between GMFCS and pelvic parameters ( Pelvic Incidence, Pelvic Tilt) and plumb line of C7. Case report: Isis born 1/10/2005 GMFCS

Dr J‐C. Bernard, J. Deceuninck, E. Loustalet, E. Morel, A. Combey, J. Sutton, E. Berthonnaud, Dr E. Chaléat‐Valayer.

Centre Médico‐Chirurgical des Massues.Croix‐Rouge française. bernard‐mpr@cmcr‐massues.com

Sagittal X‐ray parameters in walking or ambulating children with cerebral palsy. Annals of Physical and Rehabilitation Medicine. 2013 ; 56 (2) : 123‐133.

Motor function levels and pelvic parameters in walking or ambulating cerebral palsy children

Page 2: Motor function pelvic parameters in walking or … between GMFCS and pelvic parameters ( Pelvic Incidence, Pelvic Tilt) and plumb line of C7. Case report: Isis born 1/10/2005 GMFCS

GMFCS and sagittal spine in a cerebral palsypopulation

• Objectives: to allow a relation between motor function and pelvis shape in a cerebral palsy population level I to IV on Gross Motor Function Classification System (GMFCS). This study is based on sagittal X‐Ray of spine in standing position which is analyzed by Optispine® software.

Page 3: Motor function pelvic parameters in walking or … between GMFCS and pelvic parameters ( Pelvic Incidence, Pelvic Tilt) and plumb line of C7. Case report: Isis born 1/10/2005 GMFCS

GMFCS

Palisano R, Rosenbaum P, Walter S, Russell D, Wood E, Galuppi B. Development and reliability of a system to classify gross motor function in children with cerebral palsy. Dev Med Child Neurol. 1997;39(4):214‐23.

Page 4: Motor function pelvic parameters in walking or … between GMFCS and pelvic parameters ( Pelvic Incidence, Pelvic Tilt) and plumb line of C7. Case report: Isis born 1/10/2005 GMFCS

GMFCS and pelvic parameters in walking or ambulating cerebral palsy children

Results

p valuer

GMFCS and PI p=0.0130.231

GMFCS and PT p=0.0210.216

GMFCS and HC7 p=0.4900.066

Correlations between GMFCS and pelvic parameters ( Pelvic Incidence, Pelvic Tilt) and plumb line of C7.

Page 5: Motor function pelvic parameters in walking or … between GMFCS and pelvic parameters ( Pelvic Incidence, Pelvic Tilt) and plumb line of C7. Case report: Isis born 1/10/2005 GMFCS

Case report: Isis born 1/10/2005GMFCS 1

Nov 2013: SS 40° L1L5 42° T4T12 44°PI 44° PT ‐8°

Déc 2009: SS 60° L1L5 60° T4T12 27°PI 48° PT ‐13°

Page 6: Motor function pelvic parameters in walking or … between GMFCS and pelvic parameters ( Pelvic Incidence, Pelvic Tilt) and plumb line of C7. Case report: Isis born 1/10/2005 GMFCS

Page 7: Motor function pelvic parameters in walking or … between GMFCS and pelvic parameters ( Pelvic Incidence, Pelvic Tilt) and plumb line of C7. Case report: Isis born 1/10/2005 GMFCS

Results: Our results are about 114 patients who are aged 12.35 in mean (4‐18). There is a significative correlation between GMFCS and pelvic incidence (PI) (p=0.013) and between GMFCS and pelvic tilt (PT) (p=0.021) for the all population.

Discussion: There is an adaptation of pelvic parameters according to the GMFCS. The pelvic tilt will adjust with the GMFCS: the sacrum is in front (negative PT) of femoral heads for level I and gradually passed back (positive PT) for levels II, III and IV.

Page 8: Motor function pelvic parameters in walking or … between GMFCS and pelvic parameters ( Pelvic Incidence, Pelvic Tilt) and plumb line of C7. Case report: Isis born 1/10/2005 GMFCS

Discussion: GMFCS

Kevin 15 years oldGMFCS I

Samir 15 ansGMFCS IIIGMFCS 2: 16 years old

Page 9: Motor function pelvic parameters in walking or … between GMFCS and pelvic parameters ( Pelvic Incidence, Pelvic Tilt) and plumb line of C7. Case report: Isis born 1/10/2005 GMFCS

Low PI High PI

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