Asymmetric Posture in Adolescents with Refractory Epilepsy and Mental Retardation, the Development of a Measuring Tool.
Abstract number :
3.030
Submission category :
Year :
2000
Submission ID :
1273
Source :
www.aesnet.org
Presentation date :
12/2/2000 12:00:00 AM
Published date :
Dec 1, 2000, 06:00 AM
Authors :
Ad A F Lammers, Gerard J In't Veld, Francis Y Tan, Paul A J Boon, Epilepsy Ctr Kempenhaeghe, Heeze, Netherlands.
RATIONALE: Although a common feature of institutionalized adolescents with refractory epilepsy and mental retardation (MR), asymmetric posture without evidence for underlying orthopedic or specific neurological abnormalities has been poorly described in the literature. This study aims at developing a tool to measure this asymmetric posture. METHODS: Three cooperative patients (mean age: 14 years) with an asymmetric posture, refractory epilepsy and MR (developmental age of 3, 4 and 6 years respectively) were examined and compared with 3 age-matched healthy adolescents. In all patients the center of gravity projected outside the midline between both feet and the waist triangle was asymmetric. There also was a difference in shoulder height or shoulder protraction. From specific reference points distances were measured in a digital coordinate system and a dorsal view: left-right difference in shoulder heigth (Ds), difference in waist height (Dw) and distance between the perpendiculars from C7 and buttock midline (Db). In a lateral view distances were measured between the perpendiculars from the external auditory meatus and the fibular head (Df), the lateral malleolus (Dm) and the acromioclavicular joint (Da) respectively. Average values of distances were calculated based on 3 consecutive digital camera shots with subjects in standing and sitting position and a customized software package (Adobe Photoshop 5.5 LE). RESULTS: When compared to the healthy subjects, asymmetric patients showed an increased distance of Ds, Dw and Db of 300%, 200% and 500% respectively. Df, Dm and Da were 63%, 39% and 161% larger in the patient group. Differences became even more important when patients were measured in sitting position. CONCLUSIONS: The methodology that was developed allowed to reproducibly measure asymmetric body posture in adolescents with refractory epilepsy and MR. The results of this feasibility study are encouraging. The next step is to study a larger population and determine whether the asymmetry has specific features and/or a progressive nature.