Impact of Gait Analysis on Surgical Outcomes

描述（由申请方提供）：步态分析测试已用于协助骨科医生制定步态异常儿童（尤其是脑瘫儿童）的治疗计划。先前的研究表明，步态分析测试显著影响这些患者的手术决策。然而，还没有对照研究来确定步态分析和随后的手术决策变化是否会影响临床结果。因此，步态分析在临床实践中的使用仍然存在争议。本研究的目的是进行一项随机对照试验，以评估术前步态分析对脑瘫患儿手术结果的影响。具体目的是确定使用步态分析数据是否导致（1）行走能力和效率的更大改善，（2）粗大运动功能的更大改善，（3）整体患者健康和生活质量的更大改善，以及（4）与步态分析数据不可用时提供的治疗相比，对额外治疗的需求更少。 本研究为随机对照试验。患者将随机分配其术前步态分析数据是否纳入治疗决策过程。将对所有患者进行全面的术前和术后1年步态分析研究，沿着粗大运动功能测试和问卷调查，以评估儿童的总体健康状况。术后，将由独立的儿科骨科医生评估是否需要额外治疗。1-将在治疗决策过程中步态数据可用的患者与步态数据不可用的患者之间比较1年结局。结果将确定步态分析测试的使用是否改善了因脑瘫而有行走问题的儿童的临床结果。

DESCRIPTION (provided by the applicant): Gait analysis testing has been used to assist orthopedic surgeons in developing treatment plans for children with gait abnormalities, particularly children with cerebral palsy. Previous studies have shown that gait analysis testing significantly impacts surgical decision-making for these patients. However, no controlled studies have been done to determine whether gait analysis and the subsequent changes in surgical decision-making affect clinical outcomes. Consequently, the use of gait analysis in clinical practice remains controversial. The purpose of this study is to conduct a randomized controlled trial to assess the effects of preoperative gait analysis on surgical outcomes in ambulatory children with cerebral palsy. The specific aims are to determine whether the use of gait analysis data results in (1) greater improvements in walking ability and efficiency, (2) greater improvements in gross motor function, (3) greater improvements in overall patient well being and quality of life, and (4) less need for additional treatment compared with treatment provided when gait analysis data are not available. This study will be a randomized controlled trial. Patients will be randomized as to whether or not their preoperative gait analysis data are included in the treatment decision-making process. Comprehensive pre and 1-year postoperative gait analysis studies will be performed for all patients, along with gross motor function testing and questionnaires that assess a child's general health and well being. Postoperatively, the need for additional treatments will be assessed by an independent pediatric orthopaedic surgeon. 1-year outcomes will be compared between the patients whose gait data were available during the treatment decision-making process and the patients whose gait data were not available. The results will determine whether the use of gait analysis testing improves clinical outcomes in children who have walking problems due to cerebral palsy.