A New Approach in the Clinical Decision - Making for Cerebral Palsy Using Three - Dimensional Subject - Specific Musculoskeletal Reconstructions

Abir Massaad; Ayman Assi; Ziad Bakouny; Wafa Skalli; Ismat Ghanem

doi:10.12816/0031524

Article Details

A New Approach in the Clinical Decision - Making for Cerebral Palsy Using Three - Dimensional Subject - Specific Musculoskeletal Reconstructions

Authors:

Abir Massaad | Ayman Assi | Ziad Bakouny | Wafa Skalli | Ismat Ghanem

Publisher:

Lebanese Order of Physicians : Scientific Committee

Main Topics:

Medicine

Journal:

Lebanese Medical Journal 2016 Vol.64 Issue 3, pp.152-159

Document Type:

Article

Publication Date:

9/2016

Document Language:

English

Document ID (Org No.):

94316

Frequency:

Quarterly

pISSN:

00239852

DOI:

10.12816/0031524

Descriptors:

Keywords:

Abstract:

 Cerebral palsy (CP) is a neurological disorderwhich can cause muscular spasticity. Children with this conditionsuffer from a combination of gait deviations, skeletaldeformities and muscular abnormalities. Precise evaluationof each of these three components is crucial for managementplanning in children with CP. The aim of this study is toreview the latest innovative methods used for three-dimensional(3D) gait analysis and musculoskeletal modeling inchildren with cerebral palsy. 3D gait analysis is a quantitativeobjective method based on the use of infrared cameras.It allows the evaluation of dynamic joint angles, forces andmoments applied on joints and is usually coupled with dynamicelectromyography. Skeletal evaluation is usually basedon two-dimensional X-rays and physical examination in clinicalpractice. However, a novel method based on stereoradiographic3D reconstruction of biplanar low dose X-rays allowsa more thorough evaluation of skeletal deformities, and inparticular torsional anomalies. Muscular evaluation of childrenwith CP is most commonly based on magnetic resonanceimaging, whereby delimitation of lower limb muscleson axial slices allows 3D reconstruction of these muscles.Novel innovative techniques allow similar reconstructions byextrapolation, thus limiting the necessary quantity of axialslices that need to be manually delimitated.

 La paralysie cérébrale (PC) est un syndromeneurologique qui peut causer une spasticité musculaire. Lesenfants ayant ce syndrome souffrent d’une combinaison detroubles de la marche, déformations squelettiques et anomaliesmusculaires. L’évaluation précise de chacune de ces troiscomposantes est cruciale dans la prise en charge des enfantsayant une PC. Le but de cette étude est de passer en revueles méthodes innovatrices utilisées pour l’analyse de lamarche tridimensionnelle (3D) et la modélisation musculosquelettiquechez les enfants ayant une PC. L’analyse quantifiéede la marche permet l’évaluation des angles dynamiquesarticulaires, des forces et moments articulaires et estcouplée à une électromyographie dynamique. L’évaluationsquelettique est habituellement basée sur des radiographiesbidimensionnelles et l’examen clinique. En revanche, unenouvelle méthode basée sur une reconstruction 3D stéréoradiographiquedes radiographies biplanaires à basse dosed’irradiation permet l’évaluation des troubles de torsion.L’évaluation musculaire des enfants ayant une PC est le plussouvent basée sur l’imagerie par résonance magnétique, durantlaquelle la délimitation des contours musculaires desmembres inférieurs sur les coupes axiales permet la reconstructionmusculaire en 3D. Une méthode innovatrice permetdes reconstructions musculaires grâce à des extrapolations,limitant ainsi le nombre nécessaire de coupes axiales à délimitermanuellement.

Article Details

A New Approach in the Clinical Decision - Making for Cerebral Palsy Using Three - Dimensional Subject - Specific Musculoskeletal Reconstructions

Authors:

Abir Massaad | Ayman Assi | Ziad Bakouny | Wafa Skalli | Ismat Ghanem

Publisher:

Lebanese Order of Physicians : Scientific Committee

Main Topics:

Medicine

Journal:

Lebanese Medical Journal 2016 Vol.64 Issue 3, pp.152-159

Document Type:

Article

Publication Date:

9/2016

Document Language:

English

Document ID (Org No.):

94316

Frequency:

Quarterly

pISSN:

00239852

DOI:

10.12816/0031524

Descriptors:

DECISION MAKING

QUADRIPLEGIA

MUSCULOSKELETAL DISEASES

SURGICAL RECONSTRUCTION

NERVOUS SYSTEM DISEASES

CLINICAL MEDICINE

CHILDREN

Cerebral Palsy

Three - Dimensional

Musculoskeletal Reconstruction

Gait Analysis

Modeling

Issues

Article Details

Authors: Abir Massaad | Ayman Assi | Ziad Bakouny | Wafa Skalli | Ismat Ghanem

Publisher: Lebanese Order of Physicians : Scientific Committee

Main Topics: Medicine

Journal: Lebanese Medical Journal 2016 Vol.64 Issue 3, pp.152-159

Document Type: Article

Publication Date: 9/2016

Document Language: English

Document ID (Org No.): 94316

Frequency: Quarterly

pISSN: 00239852

DOI: 10.12816/0031524

Descriptors:

Issues

Authors:

Abir Massaad | Ayman Assi | Ziad Bakouny | Wafa Skalli | Ismat Ghanem

Publisher:

Lebanese Order of Physicians : Scientific Committee

Main Topics:

Medicine

Journal:

Lebanese Medical Journal 2016 Vol.64 Issue 3, pp.152-159

Document Type:

Article

Publication Date:

9/2016

Document Language:

English

Document ID (Org No.):

94316

Frequency:

Quarterly

pISSN:

00239852

DOI:

10.12816/0031524