Gait analysis in patients operated on for sacrococcygeal teratoma

Antonio Zaccara, Barbara D. Iacobelli, Ottavio Adorisio, Maurizio Petrarca, Giuseppe Di Rosa, Marcello M. Pierro, Pietro Bagolan

Research output: Contribution to journalArticle

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Abstract

Background Long-term follow-up of sacrococcygeal teratoma (SCT) is well established; however, little is known about the effects of extensive surgery in the pelvic and perineal region, which involves disruption of muscles providing maximal support in normal walking. Methods Thirteen patients operated on at birth for SCT with extensive muscle dissection underwent gait studies with a Vicon 3-D motion analysis system with 6 cameras. Results were compared with 15 age-matched controls. Statistical analysis was performed with Mann-Whitney test; correlations were sought with Spearman's correlation coefficient. Results All subjects were independent ambulators, and no statistically significant differences were seen in walking velocity and stride length. However, in all patients, toe-off occurred earlier (at 58% ± 1.82% of stride length) than controls (at 65.5% ± 0.52%; P <.05). On kinetics, all patients exhibited, on both limbs, a significant reduction of hip extensory moment (-0.11 ± 0.11 left; -0.16 ± 0.15 right v 1.19 ± 0.08 Newtonmeter/kg; P <.05) and of ankle dorsi/plantar moment (-0.07 ± 0.09 right; -0.08 ± 0.16 v -0.15 ± 0.05 Nm/kg, p <0.05). Knee power was also significantly reduced (0.44 ± 0.55 right, 0.63 ± 0.45 left v 0.04 ± 0.05 W/kg), whereas ankle power was increased (3 ± 1.5 right; 2.8 ± 0.9 left v 1.97 ± 0.2 W/kg; P <.05). No statistically significant correlation was found between tumor size and either muscle power generation or flexory/extensory moments. Conclusions Patients operated on for SCT exhibit nearly normal gait patterns. However, this normal pattern is accompanied by abnormal kinetics of some ambulatory muscles, and the extent of these abnormalities appears to be independent of tumor size. A careful follow-up is warranted to verify if such modifications are stable or progress over the years, thereby impairing ambulatory potential or leading to early arthrosis.

Original languageEnglish
Pages (from-to)947-952
Number of pages6
JournalJournal of Pediatric Surgery
Volume39
Issue number6
DOIs
Publication statusPublished - Jun 2004

Fingerprint

Teratoma
Gait
Muscles
Ankle
Walking
Joint Diseases
Toes
Pelvis
Dissection
Hip
Neoplasms
Knee
Extremities
Parturition

Keywords

  • gait analysis
  • Sacrococcygeal teratoma

ASJC Scopus subject areas

  • Surgery

Cite this

Gait analysis in patients operated on for sacrococcygeal teratoma. / Zaccara, Antonio; Iacobelli, Barbara D.; Adorisio, Ottavio; Petrarca, Maurizio; Di Rosa, Giuseppe; Pierro, Marcello M.; Bagolan, Pietro.

In: Journal of Pediatric Surgery, Vol. 39, No. 6, 06.2004, p. 947-952.

Research output: Contribution to journalArticle

Zaccara, Antonio ; Iacobelli, Barbara D. ; Adorisio, Ottavio ; Petrarca, Maurizio ; Di Rosa, Giuseppe ; Pierro, Marcello M. ; Bagolan, Pietro. / Gait analysis in patients operated on for sacrococcygeal teratoma. In: Journal of Pediatric Surgery. 2004 ; Vol. 39, No. 6. pp. 947-952.
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abstract = "Background Long-term follow-up of sacrococcygeal teratoma (SCT) is well established; however, little is known about the effects of extensive surgery in the pelvic and perineal region, which involves disruption of muscles providing maximal support in normal walking. Methods Thirteen patients operated on at birth for SCT with extensive muscle dissection underwent gait studies with a Vicon 3-D motion analysis system with 6 cameras. Results were compared with 15 age-matched controls. Statistical analysis was performed with Mann-Whitney test; correlations were sought with Spearman's correlation coefficient. Results All subjects were independent ambulators, and no statistically significant differences were seen in walking velocity and stride length. However, in all patients, toe-off occurred earlier (at 58{\%} ± 1.82{\%} of stride length) than controls (at 65.5{\%} ± 0.52{\%}; P <.05). On kinetics, all patients exhibited, on both limbs, a significant reduction of hip extensory moment (-0.11 ± 0.11 left; -0.16 ± 0.15 right v 1.19 ± 0.08 Newtonmeter/kg; P <.05) and of ankle dorsi/plantar moment (-0.07 ± 0.09 right; -0.08 ± 0.16 v -0.15 ± 0.05 Nm/kg, p <0.05). Knee power was also significantly reduced (0.44 ± 0.55 right, 0.63 ± 0.45 left v 0.04 ± 0.05 W/kg), whereas ankle power was increased (3 ± 1.5 right; 2.8 ± 0.9 left v 1.97 ± 0.2 W/kg; P <.05). No statistically significant correlation was found between tumor size and either muscle power generation or flexory/extensory moments. Conclusions Patients operated on for SCT exhibit nearly normal gait patterns. However, this normal pattern is accompanied by abnormal kinetics of some ambulatory muscles, and the extent of these abnormalities appears to be independent of tumor size. A careful follow-up is warranted to verify if such modifications are stable or progress over the years, thereby impairing ambulatory potential or leading to early arthrosis.",
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AU - Zaccara, Antonio

AU - Iacobelli, Barbara D.

AU - Adorisio, Ottavio

AU - Petrarca, Maurizio

AU - Di Rosa, Giuseppe

AU - Pierro, Marcello M.

AU - Bagolan, Pietro

PY - 2004/6

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N2 - Background Long-term follow-up of sacrococcygeal teratoma (SCT) is well established; however, little is known about the effects of extensive surgery in the pelvic and perineal region, which involves disruption of muscles providing maximal support in normal walking. Methods Thirteen patients operated on at birth for SCT with extensive muscle dissection underwent gait studies with a Vicon 3-D motion analysis system with 6 cameras. Results were compared with 15 age-matched controls. Statistical analysis was performed with Mann-Whitney test; correlations were sought with Spearman's correlation coefficient. Results All subjects were independent ambulators, and no statistically significant differences were seen in walking velocity and stride length. However, in all patients, toe-off occurred earlier (at 58% ± 1.82% of stride length) than controls (at 65.5% ± 0.52%; P <.05). On kinetics, all patients exhibited, on both limbs, a significant reduction of hip extensory moment (-0.11 ± 0.11 left; -0.16 ± 0.15 right v 1.19 ± 0.08 Newtonmeter/kg; P <.05) and of ankle dorsi/plantar moment (-0.07 ± 0.09 right; -0.08 ± 0.16 v -0.15 ± 0.05 Nm/kg, p <0.05). Knee power was also significantly reduced (0.44 ± 0.55 right, 0.63 ± 0.45 left v 0.04 ± 0.05 W/kg), whereas ankle power was increased (3 ± 1.5 right; 2.8 ± 0.9 left v 1.97 ± 0.2 W/kg; P <.05). No statistically significant correlation was found between tumor size and either muscle power generation or flexory/extensory moments. Conclusions Patients operated on for SCT exhibit nearly normal gait patterns. However, this normal pattern is accompanied by abnormal kinetics of some ambulatory muscles, and the extent of these abnormalities appears to be independent of tumor size. A careful follow-up is warranted to verify if such modifications are stable or progress over the years, thereby impairing ambulatory potential or leading to early arthrosis.

AB - Background Long-term follow-up of sacrococcygeal teratoma (SCT) is well established; however, little is known about the effects of extensive surgery in the pelvic and perineal region, which involves disruption of muscles providing maximal support in normal walking. Methods Thirteen patients operated on at birth for SCT with extensive muscle dissection underwent gait studies with a Vicon 3-D motion analysis system with 6 cameras. Results were compared with 15 age-matched controls. Statistical analysis was performed with Mann-Whitney test; correlations were sought with Spearman's correlation coefficient. Results All subjects were independent ambulators, and no statistically significant differences were seen in walking velocity and stride length. However, in all patients, toe-off occurred earlier (at 58% ± 1.82% of stride length) than controls (at 65.5% ± 0.52%; P <.05). On kinetics, all patients exhibited, on both limbs, a significant reduction of hip extensory moment (-0.11 ± 0.11 left; -0.16 ± 0.15 right v 1.19 ± 0.08 Newtonmeter/kg; P <.05) and of ankle dorsi/plantar moment (-0.07 ± 0.09 right; -0.08 ± 0.16 v -0.15 ± 0.05 Nm/kg, p <0.05). Knee power was also significantly reduced (0.44 ± 0.55 right, 0.63 ± 0.45 left v 0.04 ± 0.05 W/kg), whereas ankle power was increased (3 ± 1.5 right; 2.8 ± 0.9 left v 1.97 ± 0.2 W/kg; P <.05). No statistically significant correlation was found between tumor size and either muscle power generation or flexory/extensory moments. Conclusions Patients operated on for SCT exhibit nearly normal gait patterns. However, this normal pattern is accompanied by abnormal kinetics of some ambulatory muscles, and the extent of these abnormalities appears to be independent of tumor size. A careful follow-up is warranted to verify if such modifications are stable or progress over the years, thereby impairing ambulatory potential or leading to early arthrosis.

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