Joint kinetics: methods, interpretation and treatment decision-making in children with cerebral palsy and myelomeningocele

Computerized gait analysis has become an integral part of the treatment decision-making process in many clinical settings. The integration of kinetic data, more specifically joint moments and powers, is a relatively new addition to other types of data including joint kinematics, temporal and stride parameters and electromyography. Joint kinetic data is an important contribution to the understanding of the cause of certain gait abnormalities which are not provided by the other measures. Its utility is not only limited to the surgical decision-making process in persons with cerebral palsy and myelomeningocele but also in the orthosis decision-making process. At the time of this writing, its use as a surgical decision-making tool is limited to a few types of treatment. However, systematic study of the effects of treatment on the joint kinetics and the relationship of deviations at one joint with adjacent joints will improve our understanding of these data and how they can become an integral part of the treatment decision-making process. A review of the methods, pointers on interpretation and specific data examples will provide the reader with a detailed introduction to joint kinetics.