Gait Problems in Cerebral Palsy: Identification, Patient Goals, and Surgical Treatment (integrated online resource)

Tom F Novacheck, M.D., Pediatric Orthopedic Surgeon, Chair of the Cerebral Palsy Institute, Gillette Children’s, and Professor, University of Minnesota Department of Orthopedic Surgery.

Dr Novacheck is a Pediatric Orthopedic Surgeon at Gillette Children’s (St. Paul, Minnesota) since 1991 following his fellowship training in Paediatric Orthopaedics at Newington Children’s Hospital (Connecticut).  He has been a member of the Gillette/Connecticut Children’s/KU Leuven Gait Analysis Course Faculty since 1992 and course director when hosted in MN. At Gillette, he is Chair of the Cerebral Palsy Institute and is a professor of Orthopaedic Surgery at the University of Minnesota (Minneapolis, Minnesota). His practice currently is focused on caring for individuals with cerebral palsy and hip dysplasia. He is past president of the American Academy of Cerebral Palsy and Developmental Medicine Gait (AACPDM) in 2021-2022, past president of the Gait and Clinical Movement Analysis Society (GCMAS) in 2001, and past Editor-in-Chief of Gait & Posture (1999-2002). His research interests include the analysis of normal and pathological walking, refinement and development of gait analysis techniques, and short and long-term outcomes assessment of treatment for cerebral palsy gait dysfunction and he has published more than 70 peer reviewed articles and 25 book chapters.

Steven E. Koop, M.D., Pediatric Orthopedic Surgeon and Professor, University of Minnesota Medical School.

Dr Koop’s worked at Gillette Children’s for his entire career and focused on the care of children with neuromuscular conditions where he had the opportunity to follow children into adulthood. This continuity provided perspective on what it means to grow up with a neuromuscular condition, and it helped him learn what was important and helpful to his patients and their families. Through leadership roles at Gillette, he participated in the work of building collaborative multidisciplinary care teams.

Authors:

Elizabeth R. Boyer, PhD
Clinical Scientist, Gillette Children’s, St. Paul; Adjunct Assistant Professor, Department of Orthopedic Surgery, University of Minnesota, Minneapolis, MN, USA.

Deven Carroll, MD
Orthopedic Surgery Resident, Henry Ford Health, Detroit, MI, USA.

Trenton Cooper, DO, MS, FAAOS
Pediatric Orthopedic Surgeon, Gillette Children’s, St. Paul, MN, USA.

Alison J. Dittmer, MD
Hip Preservation Surgeon, Gillette Children’s, St. Paul; Assistant Professor, Department of Orthopedic Surgery, University of Minnesota, Minneapolis, MN, USA.

Michelle Engberg, PT, DPT
Physical Therapist, Gillette Children’s, St. Paul, MN, USA.

Heather Forst, MA, OTR/L, BCP
Occupational Therapist, Clinical Educator, Gillette Children’s, St. Paul, MN, USA.

Andrew G. Georgiadis, MD
Pediatric Orthopedic Surgeon, Clinical Manager of James R. Gage Center for Gait and Motion Analysis, Gillette Children’s, St. Paul; Associate Professor, Department of Orthopedic Surgery, University of Minnesota, Minneapolis, MN, USA.

Michael T. Healy, MD
Pediatric Orthopedic Surgeon, Chief of Orthopedic Surgery, Gillette Children’s, St. Paul; Assistant Professor, Department of Orthopedic Surgery, University of Minnesota, Minneapolis, MN, USA.

Peter Kim, MD, PhD
Pediatric Neurosurgeon, Medical Director, Surgical Services and Neurosurgery, Craniofacial, and ENT, Gillette Children’s, St. Paul, MN, USA.

Steven E. Koop, MD
Retired Pediatric Orthopedic Surgeon, Gillette Children’s, St. Paul; Professor, Department of Orthopedic Surgery, University of Minnesota, Minneapolis, MN, USA.

Jennifer Laine, MD
Pediatric Orthopedic Surgeon, Medical Director, Research, Gillette Children’s, St. Paul; Associate Professor, Department of Orthopedic Surgery, University of Minnesota, Minneapolis, MN, USA.

Daniel J. Miller, MD
Pediatric Orthopedic Surgeon, Gillette Children’s, St. Paul; Assistant Professor, Department of Orthopedic Surgery, University of Minnesota, Minneapolis, MN, USA.

Kyle Miller, MD
Pediatric Orthopedic Surgeon, Gillette Children’s, St. Paul, MN, USA.

Nickolas Nahm, MD
Pediatric Orthopedic Surgeon, Gillette Children’s, St. Paul; Assistant Professor, Department of Orthopedic Surgery, University of Minnesota, Minneapolis, MN, USA.

Jennifer Nelson, DPT
Physical Therapist, Gillette Children’s, St. Paul, MN, USA.

Jackie Norling, PT
Physical Therapist, Gillette Children’s, St. Paul, MN, USA.

Tom F. Novacheck, MD
Pediatric Orthopedic Surgeon, Chair, Cerebral Palsy Institute, Gillette Children’s, St. Paul; Professor, Department of Orthopedic Surgery, University of Minnesota, Minneapolis, MN, USA.

Therese O’Bright, DPT
Physical Therapist, Gillette Children’s, St. Paul, MN, USA.

Jackie Price, PT
Physical Therapist, Gillette Children’s, St. Paul, MN, USA.

Rocio H. Riveros-Charry, DPT
Physical Therapist, Gillette Children’s, St. Paul, MN, USA.

Amy Schulz, MS, PT
Physical Therapist, Clinical Educator, Gillette Children’s, St. Paul, MN, USA.

Emmalynn J. Sigrist, DO
Pediatric Orthopedic Surgeon, Gillette Children’s, St. Paul; Assistant Professor, Department of Orthopedic Surgery, University of Minnesota, Minneapolis, MN, USA.

Sue Sohrweide, PT
Physical Therapist, Gillette Children’s, St. Paul, MN, USA.

Jean L. Stout, PT, PhD
Physical Therapist, Gillette Children’s, St. Paul, MN, USA.

Stephen Sundberg, MD
Retired Pediatric Orthopedic Surgeon, Gillette Children’s, St. Paul; Assistant Professor, Department of Orthopedic Surgery, University of Minnesota, Minneapolis, MN, USA.

Katie Walt, DPT
Physical Therapist, Gillette Children’s, St. Paul, MN, USA.

Marcie Ward, MD
Pediatric Rehabilitation Medicine Physician, Gillette Children’s, St. Paul, MN, USA.

Elizabeth W. Weber, MD
Pediatric Orthopedic Surgeon, Shriners Children’s New England, Springfield, Massachusetts, USA.

Katie Wilkins, DPT
Physical Therapist, Gillette Children’s, St. Paul, MN, USA.

Commentary Authors:

Hank Chambers, MD
Pediatric Orthopedic Surgeon, David Sutherland Director of Cerebral Palsy Research; Rady Children’s Hospital in San Diego, San Diego, CA, USA.

Jon Davids, MD
Assistant Chief, Orthopedic Surgery; Medical Director, Motion Analysis Laboratory, Shriners Hospitals for Children; Ben Ali Chair in Pediatric Orthopedics, Department of Orthopedic Surgery, University of California Davis, Sacramento, CA, USA.

Thomas Dreher, MD
Professor and Chief, Pediatric Orthopaedics and Traumatology Department, University Children’s Hospital and Balgrist University Hospital, Zurich, Switzerland.

Kerr Graham, MD, FRCS (Ed), FRACS
Professor of Orthopaedic Surgery, University of Melbourne; Director, Hugh Williamson Gait Laboratory, Royal Children’s Hospital, Melbourne, Australia.

Robert Kay, MD
Chief, Division of Orthopedic Surgery; Director, Jackie and Gene Autry Orthopedic Center; Director, Neuromuscular Program; Associates Chair in Orthopedics, Children’s Hospital Los Angeles; Clinical Scholar and Professor of Orthopedic Surgery, Keck School of Medicine of USC, Los Angeles, CA, USA.

James McCarthy, MD, MHCM
Director, Division of Pediatric Orthopedics; Medical Director, Motion Analysis Laboratory; Co-Director, Limb Lengthening and Reconstruction Center; Alvin Crawford Chair in Pediatric Orthopedics, Cincinnati Children’s; Professor, Department of Orthopedic Surgery, College of Medicine, University of Cincinnati, Cincinnati, OH, USA.

Unni Narayanan, MBBS, MSc, FRCS(C)
Pediatric Orthopaedic Surgeon and Professor, Departments of Surgery & Rehabilitation Sciences Institute Division of Orthopaedic Surgery, University of Toronto; Senior Associate Scientist, Child Health Evaluative Sciences Program, The Hospital for Sick Children; Adjunct Senior Scientist, Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada.

Kristan Pierz, MD
Orthopedist, Orthopedics, Connecticut Children’s; Medical Director, Center for Motion Analysis, Hartford, CT, USA.

Jason Rhodes, MD
Orthopaedic Surgeon; Director of Cerebral Palsy and Neuromuscular Program, Children’s Hospital Colorado, Aurora, CO, USA.

Erich Rutz, MD, PhD, FRACS
Associate Professor, Department of Paediatrics; Bob
Dickens Chair, Paediatric Orthopaedic Surgery, The University of Melbourne; Clinical Director, Hugh Williamson Gait Laboratory; Consultant Paediatric Orthopaedic Surgeon, The Royal Children’s Hospital Melbourne, Melbourne, Australia.

Jeffrey Shilt, MD
Orthopedic Surgeon and Medical Director, Motion Analysis Lab; Professor of Orthopedics and Scoliosis Surgery, Baylor College of Medicine, Texas Children’s, TX, USA.

Benjamin Shore, MD, MPH, FRCSC Associate Professor, Orthopedic Surgery, Harvard Medical School; Co-Director, Cerebral Palsy and Spasticity Center, Boston Children’s Hospital, Boston, MA, USA.

M. Wade Shrader, MD
Pediatric Orthopedic Surgeon, Orthopedics, Nemours
Children’s Health, Wilmington, DE, USA.

Timothy Theologis, MSc, PhD, FRCS
Consultant Orthopaedic Surgeon, Oxford University Hospitals; Senior Clinical Lecturer, University of Oxford; Research Professor, Oxford Brooks University, Oxford, UK.

Anja Van Campenhout, MD, PhD
Pediatric Orthopaedic Surgeon, University Hospital
Pellenberg, Leuven, Belgium.

Contents

Author Appointments

Commentary Author Appointments

Foreword

Introduction

Videos

SECTION A: Age 4–7 years

1 Patient and Family Priorities: Principles, Tools, and Gait Outcomes Assessment List (GOAL) Results in Children 4 to 7 years old at Gillette Children’s

Elizabeth R. Boyer, Jean L. Stout, Katie Walt, and Steven E. Koop

2 Multidisciplinary Evaluation and Selective Dorsal Rhizotomy for Permanent Tone Management

Marcie Ward, Jennifer Laine, and Peter Kim

3 Rehabilitation after Selective Dorsal Rhizotomy

Michelle Engberg, Heather Forst, Jackie Norling, Therese O’Bright, Jackie Price, Amy Schulz, and Katie Wilkins

SECTION B: Age 8–12 years

4 Patient and Family Priorities and Gait Outcomes Assessment List (GOAL) Results in Children 8 to 12 years old at Gillette Children’s

Jean L. Stout, Elizabeth R. Boyer, Katie Walt, and Steven E. Koop

5 Femoral Anteversion

Andrew G. Georgiadis

6 Tibiofibular Torsion

Andrew G. Georgiadisvi

7 Foot Deformity

Stephen Sundberg and Sue Sohrweide

8 Iliopsoas

Trenton Cooper and Jennifer Nelson

9 Adductor

Kyle Miller and Jennifer Nelson

10 Hamstrings

Deven Carroll, Michael T. Healy, and Daniel J. Miller

11 Rectus Femoris

Nickolas Nahm and Michael T. Healy

12 Gastrocsoleus

Emmalynn J. Sigrist and Rocio H. Riveros-Charry

13 Rehabilitation after Juvenile Single-Event Multilevel Surgery Procedures

Michelle Engberg, Heather Forst, Jackie Norling, Therese O’Bright, Jackie Price, Amy Schulz, and Katie Wilkins

SECTION C: Age 13–17 years

14 Patient and Family Priorities and Gait Outcomes Assessment List (GOAL) Results in Adolescents 13 to 17 years old at Gillette Children’s

Jean L. Stout, Elizabeth R. Boyer, Katie Walt, and Steven E. Koop

15 Crouch Management with Anterior Distal Femoral Hemiepiphyseodesis, Distal Femoral Extension Osteotomy, Patellar Tendon Advancement, or Tibial Tubercle Advancement

Tom F. Novacheck and Jean L. Stout

16 Adolescent Foot and Arthrodesis Procedures

Steven E. Koop and Sue Sohrweide

17 Hip Dysplasia

Alison J. Dittmer and Andrew G. Georgiadis

18 Rehabilitation after Orthopedic Surgery in Adolescents

Michelle Engberg, Heather Forst, Jackie Norling, Amy Schulz, Therese O’Bright, Jackie Price, and Katie Wilkins

Afterword

Tom F. Novacheck and Steven E. Koop

Appendices

1 Complete Item and Domain Names Derived from the Gait Outcomes Assessment List (GOAL) Questionnaire

2 Anticipated Function at Discharge

3 Physical Therapy Goals and Activities for Inpatient Rehabilitation Stay Following Selective Dorsal Rhizotomy

4 Occupational Therapy Goals and Activities for Inpatient Rehabilitation Stay Following Selective Dorsal Rhizotomy

5 Outpatient Physical Therapy Progression Months 1–12

6 Before Your Child’s Single-Event Multilevel Surgery

7 What to Expect from Your Inpatient Rehabilitation Stay Following Single-Event Multilevel Surgery

8 Surgical Procedure: Adductor Lengthening

9 Surgical Procedure

10 Surgical Procedure: Pelvic Osteotomy (With or Without) Proximal Femoral Derotation Osteotomy – Neuromuscular Diagnoses

11 Surgical Procedure: Proximal Femoral Derotational Osteotomy

12 Surgical Procedure: Psoas Lengthening

13 Surgical Procedure: Tibial Derotation Osteotomy and Gastrocnemius/Soleus Procedures

14 Surgical Procedure: Distal Femoral Extension Osteotomy (With Patellar Tendon Advancement)

15 Surgical Procedure: Ganz Periacetabular Osteotomy

16 Surgical Procedure: Rectus Femoris Transfer

17 Tibial Tubercle/Patellar Tendon Advancement

You will be given a Mac Keith Press account upon purchase and you will be able to access the online integrated platform edition of Gait Problems in Cerebral Palsy: Identification, Patient Goals, and Surgical Treatment from your ‘My Account’ page after successfully logging into our website.

This online resource is designed to help:

• Orthopaedic surgeons
• Physiatrists
• Physical therapists
• Kinesiologists
• Gait analysis experts
• Members of the interdisciplinary team involved in the care of CP patients

Please visit the ‘Gait Problems in Cerebral Palsy FAQs’ page if you have any queries.