Ambulation in spastic cerebral palsy: Analysis and predictive modeling.

摘要

Understanding the pathologies associated with spastic cerebral palsy and their influence on the gait of affected children is a complex endeavor. The myriad of interventions applied to help children overcome these pathologies serve to further complicate analysis and understanding of the underlying gait dynamics. The purpose of this dissertation was to further our understanding of both normal and pathologic gait in humans. This was accomplished by developing: (1) New methods to analyze the increased metabolic cost of pathologic gait; (2) A patient specific model implementing a new first order forward dynamic control based on angular momentum.;The normalized angular momentum of the body during gait was developed as a metric for the analysis of gait, and a correlation between metabolic requirements (i.e. work) of gait, and the variation between normal and CP populations was developed. A patient specific model was being developed using LifeMod and MSC.Adams simulating both normal and pathologic gait implementing a first order forward dynamic feed back control using angular momentum as the reference signal used to develop joint torques. This control scheme was developed as a step in the development of a clinical tool used by physicians to predict the kinematic changes in gait associated with medical interventions currently used to treat cerebral palsy. Such a tool could eventually be used to quantify the effect of interventions thus increasing the information available to clinicians and surgeons as they determine the best course of action for a given patient.