@article{VerchHirschmuellerMuelleretal.2018,
  author    = {Verch, Ronald and Hirschm{\"u}ller, Anja and M{\"u}ller, Juliane and Baur, Heiner and Mayer, Frank and M{\"u}ller, Steffen},
  title     = {Is in-toing gait physiological in children?},
  series = {Gait \& posture},
  volume    = {66},
  journal   = {Gait \& posture},
  publisher = {Elsevier},
  address   = {Clare},
  issn      = {0966-6362},
  doi       = {10.1016/j.gaitpost.2018.08.019},
  pages     = {70 -- 75},
  year      = {2018},
  abstract  = {Research question: This study aimed to establish reference values in 1-14 year old healthy children and to implement FPA-percentile curves for daily clinical use. Methods: 5910 healthy children performed at least 3 repetitions of barefoot walking over an instrumented walkway using a pressure measurement platform. The FPA [degrees] was extracted and analyzed by age and gender (mean +/- standard deviation; median with percentiles, MANOVA (age, gender) and Wilcoxon-Signed-Rank test for intra-individual side differences (alpha = 0.05). Results: FPA maximum was observed in 2-year-old children and diminished significant until the age of 4 to moderate out-toeing. For ages 5-14, no statistically significant differences in FPA values were present (p > 0.05). MANOVA confirmed age (p < 0.001) and gender (p < 0.001) as significant FPA influencing factors, without combined effect (p > 0.05). In every age group, right feet showed significantly greater out-toeing (p < 0.05). Significance: Percentile values indicate a wide FPA range in children. FPA development in young children shows a spontaneous shift towards moderate external rotation (age 2-4), whereby in-toeing <= 1-5 degrees can be present, but can return to normal. Bilateral in-toeing after the age of four and unilateral in-toeing after the age of seven should be monitored.},
  language  = {en}
}
@article{MuellerMuellerBauretal.2013,
  author    = {M{\"u}ller, Juliane and M{\"u}ller, Steffen and Baur, Heiner and Mayer, Frank},
  title     = {Intra-individual gait speed variability in healthy children aged 1-15 years},
  series = {Gait \& posture},
  volume    = {38},
  journal   = {Gait \& posture},
  number    = {4},
  publisher = {Elsevier},
  address   = {Clare},
  issn      = {0966-6362},
  doi       = {10.1016/j.gaitpost.2013.02.011},
  pages     = {631 -- 636},
  year      = {2013},
  abstract  = {Introduction: Gait speed is one of the most commonly and frequently used parameters to evaluate gait development. It is characterized by high variability when comparing different steps in children. The objective of this study was to determine intra-individual gait speed variability in children. Methods: Gait speed measurements (6-10 trials across a 3 m walkway) were performed and analyzed in 8263 children, aged 1-15 years. The coefficient of variation (CV) served as a measure for intra-individual gait speed variability measured in 6.6 +/- 1.0 trials per child. Multiple linear regression analysis was conducted to evaluate the influence of age and body height on changes in variability. Additionally, a subgroup analysis for height within the group of 6-year-old children was applied. Results: A successive reduction in gait speed variability (CV) was observed for age groups (age: 1-15 years) and body height groups (height: 0.70-1.90 m). The CV in the oldest subjects was only one third of the CV (CV 6.25 +/- 3.52\%) in the youngest subjects (CV 16.58 +/- 10.01\%). Up to the age of 8 years (or 1.40 m height) there was a significant reduction in CV over time, compared to a leveling off for the older (taller) children. Discussion: The straightforward approach measuring gait speed variability in repeated trials might serve as a fundamental indicator for gait development in children. Walking velocity seems to increase to age 8. Enhanced gait speed consistency of repeated trials develops up to age 15.},
  language  = {en}
}
@article{HirschmuellerKonstantinidisBauretal.2011,
  author    = {Hirschm{\"u}ller, Anja and Konstantinidis, Lukas and Baur, Heiner and M{\"u}ller, Steffen and Mehlhorn, Alexander and Kontermann, Julia and Grosse, Ulrich and S{\"u}dkamp, Norbert P. and Helwig, Peter},
  title     = {Do changes in dynamic plantar pressure distribution, strength capacity and postural control after intra-articular calcaneal fracture correlate with clinical and radiological outcome?},
  series = {Injury : international journal of the care of the injured},
  volume    = {42},
  journal   = {Injury : international journal of the care of the injured},
  number    = {10},
  publisher = {Elsevier},
  address   = {Oxford},
  issn      = {0020-1383},
  doi       = {10.1016/j.injury.2010.09.040},
  pages     = {1135 -- 1143},
  year      = {2011},
  abstract  = {Fractures of the calcaneus are often associated with serious permanent disability, a considerable reduction in quality of life, and high socio-economic cost. Although some studies have already reported changes in plantar pressure distribution after calcaneal fracture, no investigation has yet focused on the patient's strength and postural control. Method: 60 patients with unilateral, operatively treated, intra-articular calcaneal fractures were clinically and biomechanically evaluated >1 year postoperatively (physical examination, SF-36, AOFAS score, lower leg isokinetic strength, postural control and gait analysis including plantar pressure distribution). Results were correlated to clinical outcome and preoperative radiological findings (Bohler angle, Zwipp and Sanders Score). Results: Clinical examination revealed a statistically significant reduction in range of motion at the tibiotalar and the subtalar joint on the affected side. Additionally, there was a statistically significant reduction of plantar flexor peak torque of the injured compared to the uninjured limb (p < 0.001) as well as a reduction in postural control that was also more pronounced on the initially injured side (standing duration 4.2 +/- 2.9 s vs. 7.6 +/- 2.1 s, p < 0.05). Plantar pressure measurements revealed a statistically significant pressure reduction at the hindfoot (p = 0.0007) and a pressure increase at the midfoot (p = 0.0001) and beneath the lateral forefoot (p = 0.037) of the injured foot. There was only a weak correlation between radiological classifications and clinical outcome but a moderate correlation between strength differences and the clinical questionnaires (CC 0.27-0.4) as well as between standing duration and the clinical questionnaires. Although thigh circumference was also reduced on the injured side, there was no important relationship between changes in lower leg circumference and strength suggesting that measurement of leg circumference may not be a valid assessment of maximum strength deficits. Self-selected walking speed was the parameter that showed the best correlation with clinical outcome (AOFAS score). Conclusion: Calcaneal fractures are associated with a significant reduction in ankle joint ROM, plantar flexion strength and postural control. These impairments seem to be highly relevant to the patients. Restoration of muscular strength and proprioception should therefore be aggressively addressed in the rehabilitation process after these fractures.},
  language  = {en}
}