August 2015

august-pediatrics-cover-lrgEditor Message

emily-delzellFrom the editor: A matter of perspective

Often, especially when talking about family or intimate relationships, people qualify the meaning of normal—adding “whatever that means.” In pediatric gait training, though, normative values do exist, and parents and practitioners commonly strive to help children achieve these benchmarks.

A number of studies show that parents of children with cerebral palsy (CP) prioritize walking as a primary goal for their child, often focusing on these normal gait patterns as well as their child being able to walk independently. Research on the children’s perceptions and values, however, shows their views on the definition of normal walking—as well as their desire to achieve it—aren’t as clear-cut.

In a study of robotic gait training detailed in this issue (see “Robotic gait training doesn’t wow young patients with CP: Kids, parents differ on ‘normal’ gait,” page 7), young participants sometimes saw their current, though technically impaired, gait as normal. In addition, unlike their parents, the children didn’t explicitly express a desire to walk using nondisabled gait patterns.

Similarly, in research reported previously in LER on children’s and parents’ beliefs about the value of walking, the investigator-author noted that, by internalizing ideas about what parents and society see as “normal” gait—as well as the value of reaching that standard—children may struggle with self-image and self-esteem if they can’t achieve these goals or need to use assistive devices (see “The value of walking in children with CP: A matter of perception,” LER, January 2013, page 14).

By reflecting critically on how perspectives on gait may diverge among young patients and those most involved in their care, and by focusing on outcomes and attitudes that support the child’s needs, desires, and self-confidence, practitioners can help patients and their parents achieve feasible goals that are meaningful to the child.

By Emily Delzell, Senior Editor

News


Taller, heavier children have heightened Sever disease risk

Long-term pain warrants early ID – Children presenting with calcaneal apo­phy­sitis (Sever disease) are anthropometrically different from their peers and experience a lengthy period of pain, according to Australian study findings that underscore the importance of early intervention and…

By Katie Bell

Gait analysis for clubfoot may reveal long-term issues

Surgery more likely to alter gait – Children treated for idiopathic clubfoot by age 2 years may experience subtle changes in gait by the time they are aged 5 years, and nonoperative treatment may confer more normal movement than surgery, according to a recent study.

By Larry Hand

Robotic gait training doesn’t wow young patients with CP

Kids, parents differ on ‘normal’ gait – Although physical therapists and parents often strive for attaining “normal” gait in children with neuromotor disorders, a new study from researchers at the University of Alberta in Edmonton, Canada, indicates that…

By Brigid Galloway

Features


Growing pains: Adapting O&P devices to maturing patients

Accommodating growth without compromising fit and function is a challenge for practitioners who prescribe orthotic devices for young patients. Adjustments and add-ons—as well as educating parents about expected changes—can make for smoother transitions.

By Shalmali Pal

Childhood obesity and OA: Can early care reduce risk?

Osteoarthritis (OA) risk factors and symptoms seen in adults have been found in obese kids, who often have musculoskeletal pain. Weight loss may help, but preventing OA may also require gait and exercise interventions, particularly those that reduce pain that leads to inactivity.

By Erin Boutwell