Changes in calf properties following interventions for toe-walking
Research type
Research Study
Full title
Can clinical gait analysis and ultrasound assessment, including elastography, detect a change in the stiffness of the calf musculature in children with cerebral palsy? A comparison study of patients following serial casting, Botulinum toxin-A injection and typically developing controls.
IRAS ID
218285
Contact name
Caroline Stewart
Contact email
Sponsor organisation
RJAH Orthopaedic Hospital
Duration of Study in the UK
2 years, 7 months, 18 days
Research summary
ORLAU is a clinical department of the Robert Jones and Agnes Hunt Orthopaedic Hospital. We treat patients with a wide range of movement disorders affecting their walking or arm function. One of the most common gait issues we see is toe-walking, this is most prevalent in those patients with cerebral palsy (CP). Toe-walking in CP children arises mostly from problems in the calf muscle, we currently use gait analysis to help guide treatment management plans. Two standard interventions for such cases are serial casting and Botulinum Toxin-A injections. Using gait analysis we will be able to see changes to the gait pattern before and after the interventions, however, we want to obtain a whole clinical picture, using B-mode ultrasound, elastography and electromyography (EMG) we will be able to achieve this. These measurements will provide us with information about the muscle architecture and properties including activation. This will help us to determine the effects of the interventions. Elastography is a fairly new clinical technique that uses shear waves generated by the ultrasound probe to map the stiffness of a muscle. Stiffness of muscle is a good indication of myopathies. The additional examinations we want to carry out are all non-invasive, they will be carried out in two sessions, one before the intervention and one after. We will compare the data we collect from the children with CP to our normal database with ORLAU has ethical approval for. The final stage of this study will be to use the muscle parameters obtained by ultrasound to set parameters in a computer musculoskeletal model.
REC name
Wales REC 4
REC reference
18/WA/0254
Date of REC Opinion
4 Sep 2018
REC opinion
Further Information Favourable Opinion