Ambulation is the specific skill of biped walking, supported by braces and walking aids in patients with spina bifida. [according to: Shurtleff D. (Editor) Myelodysplasias and Extrophies (1986)]. In the last years our therapeutic goal was to enforce ambulation as early and as long as possible in these patients. In the study presented we wanted to look at the results in the children and adolescents of the outpatient clinic for spina bifida of the Cologne Children's Hospital.
The outcome measures were different across the included studies. For the details of the outcome measure used in each study, see Table 2. Barkocy et al. (2017) used the Observational Gait Scale score, the Functional Mobility Scale score, the passive end-range ankle dorsiflexion angle (with the knee extended), and the kinematic data obtained using a gait analysis system. Later, Barkocy et al. (2021) used the Patient Specific Function Scale score, the Functional Mobility Scale score, the passive end-range ankle dorsiflexion angle (with the knee extended), and the kinematic data obtained using a gait analysis system. Kratz (2020) used as outcomes a clinical observation supported by photos and the mobility skills assessment using the mobility subsection of the Pediatric Evaluation of Disability Inventory. Marcus et al. (2010) calculated the percentage of 10-s intervals in 10-min sessions in which each participant engaged TW, dividing the number of occurrences of TW by the total number of 10 s windows TW exhibited. Hodges et al. (2018) and Wilder et al. (2020) used the percentage of steps engaged in TW during each assessment session as an assessment method, while Persicke et al. (2014) and Hodges et al. (2019) used the percentage of appropriate steps. Shaw and Soto-Garcia (2021) considered as outcome measure the time spent on heel-toe walking and the occurrence of falling downstairs.
Chand T. John, Frank C. Anderson, Jill S. Higginson & Scott L. Delp (2012): Stabilisation of walking by intrinsic muscle properties revealed in a three-dimensional muscle-driven simulation, Computer Methods in Biomechanics and Biomedical Engineering, DOI:10.1080/10255842.2011.627560. Download here
For details, refer to the following PDF of the maximum isometric muscle forces from Gait2392/Gait2354, Delp1990, and Carhart2000, along with the scale factors: MuscleIsometricForces.pdf. We also conducted a comparison of CMC results from the Gait2392 walking example was made between the "scaled" Gait2392 and isometric forces from Delp (1990): Gait2392ComparisonResultsCMC.pdf. Note, that the muscles activations predicted by CMC were not significantly different between the two sets of isometric muscle force. Therefore,we do not expect these increases would greatly affect the distribution of muscle force estimates, nor the interpretation of those results. 2b1af7f3a8