Effect of Surgical Procedures for Crouch Gait

Crouch gait is a common gait deviation found in patients with cerebral palsy that is characterized by an excessive amount of flexion at the knee joint. This study aims to quantify the effect of corrective surgery on lower limb mechanics in order to determine the best procedure for a particular patient. Kinematic data were obtained from 11 patients who underwent surgical procedures to correct for crouch gait. A 3D finite element model of the lower extremity (including bone, cartilage, extensor mechanism, soft-tissue, and muscle) was developed in Abaqus/Explicit. The gait cycle of each patient was simulated both pre- and postoperatively

Effect of Corrective Surgery on Lower Limb Mechanics in Patients with Crouch Gait

Crouch gait a progressively degrading gait deviation associated with the neurological disorder cerebral palsy. If left untreated it can lead to anterior knee pain and a loss of ambulation. At present there exists no agreed upon metric for determining the surgical procedures used to treat crouch gait and there is insufficient means to analytically compare the results of different procedures. The aims of this thesis work were to create a pipeline to transform a patient’s gait analysis data into a finite element model, develop a model of sufficient complexity to evaluate a range of outcomes by which to judge the efficacy of a surgical procedure, analyze the change between pre- and post-operative models and the changes between models with different surgical procedures, and to quantify the impact of varying different surgical parameters. A generic lower limb rigid body musculoskeletal model was developed and used in conjunction with patient-specific static and dynamic motion capture to create scaling factors and joint kinematics, respectively. The musculoskeletal model was scaled and converted into a finite element model. This lower torso model was integrated with a detailed finite element model of the knee joint including patella, femur and tibia heads, associated articular cartilage, patellofemoral ligaments, patellar tendon, and quadriceps tendons. This type of combined finite element model was created for each patient, pre- and post-operatively, for a series of patient’s treated for crouch gait at Children’s Hospital Colorado. Each model was modified to replicate the surgical procedure(s) that each individual patient underwent. Comparison between pre- and post-operative models show significant improvement in tibiofemoral flexion-extension and patellar articular cartilage stress in post-operative models. In order to assess the effect of surgical parameters on muscle efficiency, the finite element model was modified such that tibiofemoral flexion-extension was controlled by adaptive muscle forces calculated using a proportional-integral feedback control system. The feedback system adjusted quadriceps and hamstrings forces to try and meet a target flexion profile. A feedback control model was created for three patients; subsequently, each model was modified to run multiple simulations with modified surgical procedures and parameters. The models were modified to include distal femoral extension osteotomy procedures of 0º, 15º, or 30º, or patella tendon advancement procedures with 0 cm, 1 cm, or 2 cm shortening. The muscle forces needed to reach the target kinematics were compared. Further simulations are required to identify clear links between surgical decisions and patient-specific parameters, but the developed model shows promise for future studies both for crouch gait and other musculoskeletal pathologies

Correspondences - 1953, March 3 - Bessie Milholland

Condolences concerning the passing of Madge Webb Riley. Handwritten (in pencil Fay Webb Gardner notes the location)https://digitalcommons.gardner-webb.edu/fay-webb-gardner-madge-webb-riley/1010/thumbnail.jp

Correspondence - 1955, January 17 - Bessie Milholland

Letter to Mrs. Fay Webb Gardner after Christmastime. Handwrittenhttps://digitalcommons.gardner-webb.edu/fay-webb-gardner-madge-webb-riley/1019/thumbnail.jp

Multiple case study of instructors utilizing classroom response systems (CRS) to achieve pedagogical goals, A

2015 Spring.Includes bibliographical references.This study examined five instructors who have employed Classroom Response Systems (CRS) for a minimum of five years. Instructors were asked their initial pedagogical goals when adopting CRS, and also to describe any changes in those goals or use of the technology since that time. Emerging themes were identified using a multiple case study methodology. All instructors said their use of CRS evolved and changed from initial adoption to their current use of the technology today. Student engagement was the single ubiquitous reason provided for choosing to employ CRS. Other potential reason for using CRS include: peer instruction via group and cooperative learning, increasing student responsibility, reducing lecture while increasing interaction, employing deep learning pedagogy, redistributing classroom power back to students, increasing student achievement, and making classroom learning more enjoyable. No single technique appeared to be required to benefit from the use of CRS. Instructors described an assortment of practices they found personally successful in a variety of classroom sizes. Some even chose to utilize the same pedagogical techniques as if they were using CRS, but purposefully eschewed the devices because they found them too constraining for the desired learning outcome. This indicates that the teaching methodology was more important that the technology. CRS seems to be suitable for performing a variety of pedagogical tasks, even if it is not the ideal way to achieve any single one. Based on this research, it appears the greatest strength of CRS is that it can proficiently accomplish a multitude of learning goals in a relatively easy manner

Four Kinds of Reproducibility in Scale Analysis

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/68060/2/10.1177_001316445501500416.pd

Investigation of the Pathogenicity of Race Mixtures of Puccinia recondita Rob. Ex Desm.

Botany and Plant Patholog