Research Topics
| Tishya WrenSummaryAffiliation: University of Southern California Country: USA Publications
Research Grants
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Detail Information
Publications
Static and dynamic gait parameters before and after multilevel soft tissue surgery in ambulating children with cerebral palsyNicholas M Bernthal
University of California Los Angeles Medical Center, Los Angeles, CA 90921, USA
J Pediatr Orthop 30:174-9. 2010..Recent studies have questioned the efficacy of releasing hip flexion contractures and the resulting ankle position after tendoachilles lengthening in ambulating children with cerebral palsy (CP)...- Differences in implementation of gait analysis recommendations based on affiliation with a gait laboratoryTishya A L Wren
Children s Orthopaedic Center, Children s Hospital Los Angeles, Los Angeles, CA 90027, United States
Gait Posture 37:206-9. 2013..Gait analysis influences the treatment decisions of surgeons regardless of affiliation with the gait laboratory, although the influence is stronger for surgeons who practice within the same institution as the gait laboratory... 
Racial disparity in fracture risk between white and nonwhite children in the United StatesTishya A L Wren
Departments of Orthopaedic Surgery and Radiology, Children s Hospital Los Angeles, Los Angeles, CA 90027, USA
J Pediatr 161:1035-40. 2012..To examine risk factors for fracture in a racially diverse cohort of healthy children in the US...
Use of a patella marker to improve tracking of dynamic hip rotation range of motionTishya A L Wren
Childrens Orthopaedic Center, Childrens Hospital Los Angeles, Los Angeles, CA 90027, USA
Gait Posture 27:530-4. 2008..The use of patella markers with knee alignment devices may therefore allow for more accurate measurement of hip rotations during clinical gait analysis than is currently possible using traditional thigh wands...- Gillette Gait Index as a gait analysis summary measure: comparison with qualitative visual assessments of overall gaitTishya A L Wren
Childrens Orthopaedic Center, Childrens Hospital Los Angeles, CA 90027, USA
J Pediatr Orthop 27:765-8. 2007..The purpose of this study was to compare GGI scores from computerized gait analysis versus qualitative visual assessments of overall gait to assess the validity of the GGI as a summary score for gait analysis... - Bone density and size in ambulatory children with cerebral palsyTishya Al Wren
Children s Orthopaedic Center, Children s Hospital Los Angeles, Los Angeles, CA 90027, USA
Dev Med Child Neurol 53:137-41. 2011..To examine the relation of axial and appendicular bone properties in ambulatory children with cerebral palsy (CP) to functional (Gross Motor Function Classification System [GMFCS]) level... - Concurrent and discriminant validity of Spanish language instruments for measuring functional health statusTishya A L Wren
Children s Orthopaedic Center, Children s Hospital Los Angeles and Shriners Hospital for Children, 4650 Sunset Boulevard, Los Angeles, CA 90027, USA
J Pediatr Orthop 28:199-212. 2008.... - Prior treatment of fracture patients in a tertiary pediatric emergency department: informal referrals from other emergency departmentsTishya A L Wren
Childrens Orthopaedic Center, Childrens Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
J Pediatr Orthop 29:137-41. 2009.... - Effects of preoperative gait analysis on costs and amount of surgeryTishya A L Wren
Children s Orthopaedic Center, Children s Hospital Los Angeles, Los Angeles, CA 90027, USA
J Pediatr Orthop 29:558-63. 2009..The purpose of this study was to determine the effects of clinical gait analysis (GA) on the costs of care in ambulatory children with cerebral palsy (CP) and the amount of surgery these children undergo... - Achilles tendon length and medial gastrocnemius architecture in children with cerebral palsy and equinus gaitTishya A L Wren
Children s Orthopaedic Center, CA, USA
J Pediatr Orthop 30:479-84. 2010..We also examined a small number of children who had undergone prior surgical lengthening of the triceps surae to address equinus contracture... - Effect of high-frequency, low-magnitude vibration on bone and muscle in children with cerebral palsyTishya A L Wren
Childrens Orthopaedic Center, Childrens Hospital, Los Angeles, Los Angeles, CA 90027, USA
J Pediatr Orthop 30:732-8. 2010..The purpose of this study was to examine the effects of this intervention on bone and muscle in children with CP... - Efficacy of clinical gait analysis: A systematic reviewTishya A L Wren
Children s Orthopaedic Center, Children s Hospital Los Angeles, Los Angeles, CA, USA
Gait Posture 34:149-53. 2011..Thus, the current evidence supports the clinical efficacy of gait analysis, particularly at the lower levels of efficacy, but additional research is needed to strengthen the evidence base at the higher levels of efficacy... - Influence of gait analysis on decision-making for lower extremity orthopaedic surgery: Baseline data from a randomized controlled trialTishya A L Wren
Children s Orthopaedic Center, Children s Hospital Los Angeles, Los Angeles, CA, USA
Gait Posture 34:364-9. 2011..7%, p=0.037). These results provide a stronger level of evidence demonstrating that gait analysis changes treatment decision-making and also reinforces decision-making when it agrees with the surgeon's original plan... - Agreement among three instruments for measuring functional health status and quality of life in pediatric orthopaedicsTishya A L Wren
Childrens Orthopaedic Center, Childrens Hospital Los Angeles, Los Angeles, CA 90027, USA
J Pediatr Orthop 27:233-40. 2007..Of the instruments used in this study, the CHQ is the easiest to administer and is a good general quality of life measure; however, the PODCI or PEDI may be preferred if information about more specific functional activities is desired... - Effects of creep and cyclic loading on the mechanical properties and failure of human Achilles tendonsTishya A L Wren
Rehabilitation Research and Development Center, Veterans Affairs Health Care System, 3801 Miranda Avenue No 153, Palo Alto, CA, USA
Ann Biomed Eng 31:710-7. 2003..The cyclically loaded specimens failed faster than would be expected if only time-dependent damage occurred, suggesting that repetitive loading also contributes to Achilles tendon injuries... - A computational model for the adaptation of muscle and tendon length to average muscle length and minimum tendon strainTishya A L Wren
Children s Orthopaedic Center, Children s Hospital Los Angeles, 4650 Sunset Boulevard, 69, Los Angeles, CA 90027, USA
J Biomech 36:1117-24. 2003..This suggests that average muscle length and minimum tendon strain may represent general principles that govern muscle and tendon length adaptation... - Prevalence of specific gait abnormalities in children with cerebral palsy: influence of cerebral palsy subtype, age, and previous surgeryTishya A L Wren
Children s Orthopaedic Center, Childrens Hospital Los Angeles, Los Angeles, California 90027, USA
J Pediatr Orthop 25:79-83. 2005..These findings provide important information for counseling ambulatory children with cerebral palsy and their families... - Cross-correlation as a method for comparing dynamic electromyography signals during gaitTishya A L Wren
Childrens Orthopaedic Center, Childrens Hospital Los Angeles, Los Angeles, CA 90027, USA
J Biomech 39:2714-8. 2006..The advantages of cross-correlation are that it considers shape of the EMG signal in addition to timing and that the assessments it provides are objective, rather than subjective... - Gastrocnemius and soleus lengths in cerebral palsy equinus gait--differences between children with and without static contracture and effects of gastrocnemius recessionTishya A L Wren
Childrens Orthopaedic Center, Childrens Hospital Los Angeles, 4650 Sunset Blvd, No 69, Los Angeles, CA 90027, USA
J Biomech 37:1321-7. 2004..04). These results support the current clinical understanding of the role of calf "tightness" in equinus gait, including the appropriateness and effectiveness of gastrocnemius recession for children with equinus contracture... - How closely do surgeons follow gait analysis recommendations and why?Tishya A L Wren
Department of Orthopaedic Surgery, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
J Pediatr Orthop B 14:202-5. 2005..Explanations for the differences included preoperative clinical or radiographic evaluation, intraoperative assessment, changes in function between gait analysis and surgery, and patient/family request... - Bone acquisition in healthy young females is reciprocally related to marrow adiposityNatascia Di Iorgi
Department of Radiology, Childrens Hospital Los Angeles, 4650 Sunset Boulevard, Los Angeles, California 90027, USA
J Clin Endocrinol Metab 95:2977-82. 2010..Considerable evidence indicates that osteoblasts and adipocytes share a common progenitor cell in the bone marrow that is capable of mutually exclusive differentiation into the cell lineages responsible for bone and fat formation... - Bone densitometry in pediatric populations: discrepancies in the diagnosis of osteoporosis by DXA and CTTishya A L Wren
Department of Radiology, Division of Orthopaedics, Children's Hospital Los Angeles, California, USA
J Pediatr 146:776-9. 2005.... - Predictive value of the Duncan-Ely test in distal rectus femoris transferRobert M Kay
Children's Orthopaedic Center, Children's Hospital Los Angeles and the Department of Orthopaedics, University of Southern California, Los Angeles, California 90027, USA
J Pediatr Orthop 24:59-62. 2004..Caution should be exercised when patients have weak quadriceps and a negative Duncan-Ely test before surgery, particularly when concurrent calf lengthening procedures are planned... - Fat mass is not beneficial to bone in adolescents and young adultsAgnieszka Janicka
Childrens Hospital Los Angeles, Los Angeles, California 90027, USA
J Clin Endocrinol Metab 92:143-7. 2007..Although muscle mass is beneficial to bone, studies on the effect of fat mass on bone have yielded conflicting results... - Timing of peak bone mass: discrepancies between CT and DXATishya A L Wren
Children s Hospital Los Angeles, Los Angeles, California 90027, USA
J Clin Endocrinol Metab 92:938-41. 2007..The time of life in which peak bone mass in the axial skeleton is attained has been the subject of considerable controversy, with estimates ranging from the time of sexual and skeletal maturity to the fifth decade of life... - Changes in pelvic rotation after soft tissue and bony surgery in ambulatory children with cerebral palsyRobert M Kay
Children's Orthopaedic Center, Children's Hospital Los Angeles, Los Angeles, California 90027, USA
J Pediatr Orthop 24:278-82. 2004.... - Bone acquisition in healthy children and adolescents: comparisons of dual-energy x-ray absorptiometry and computed tomography measuresTishya A L Wren
Department of Orthopedics, MS#81, 4650 Sunset Boulevard, Los Angeles, California 90027, USA
J Clin Endocrinol Metab 90:1925-8. 2005..Use of DXA BMD would be reasonable if adjustments for body size, pubertal status, and skeletal maturity are made, but these additional assessments add significant complexity to the studies... - Development of calcaneal gait without prior triceps surae lengthening: an examination of predictive factorsKenneth Huh
Childrens Orthopaedic Center, Childrens Hospital, Los Angeles, CA, USA
J Pediatr Orthop 30:240-3. 2010..The goal of this study was to identify patient characteristics predictive of the development of CG in patients without prior triceps surae lengthening... - Predictors of outcome of distal rectus femoris transfer surgery in ambulatory children with cerebral palsySusan A Rethlefsen
Childrens Orthopaedic Center, Childrens Hospital Los Angeles, CA 90027, USA
J Pediatr Orthop B 18:58-62. 2009..008). In conclusion, Gross Motor Function Classification System IV patients may not benefit from distal rectus femoris transfer because of increased postoperative crouch... - Excessive hip flexion during gait in patients with static encephalopathy: an examination of contributing factorsSusan A Rethlefsen
Childrens Orthopaedic Center, Childrens Hospital Los Angeles, CA 90027 USA
J Pediatr Orthop 30:562-7. 2010..The purpose of this study was to examine the contributors to excessive hip flexion during gait in children with cerebral palsy, with and without hip flexion contractures... - Bone marrow fat is inversely related to cortical bone in young and old subjectsTishya A L Wren
Department of Radiology, Childrens Hospital Los Angeles, MS 81, 4650 Sunset Boulevard, Los Angeles, California 90027, USA
J Clin Endocrinol Metab 96:782-6. 2011..Using magnetic resonance imaging, we examined whether the relation between the amount of marrow fat and cortical bone is present at multiple sites along the diaphyses of the long bones of young and old males and females... - Vitamin D status and its relation to muscle mass and muscle fat in young womenVicente Gilsanz
Department of Radiology, Keck School of Medicine, University of Southern California, Los Angeles, California 90027, USA
J Clin Endocrinol Metab 95:1595-601. 2010..Vitamin D insufficiency has now reached epidemic proportions and has been linked to increased body fat and decreased muscle strength. Whether vitamin D insufficiency is also related to adipose tissue infiltration in muscle is not known... - Weight gain following vertical expandable prosthetic titanium ribs surgery in children with thoracic insufficiency syndromeDavid L Skaggs
Children s Hospital Los Angeles, Los Angeles, CA 90027, USA
Spine (Phila Pa 1976) 34:2530-3. 2009..Retrospective review of patients from a multicenter database... - Low-level, high-frequency mechanical signals enhance musculoskeletal development of young women with low BMDVicente Gilsanz
Department of Radiology, Childrens Hospital of Los Angeles, University of Southern California, Keck School of Medicine, Los Angeles, California 90027, USA
J Bone Miner Res 21:1464-74. 2006..Twelve months of this noninvasive signal, induced as whole body vibration for at least 2 minutes each day, increased bone and muscle mass in the axial skeleton and lower extremities compared with controls... - Causes of intoeing gait in children with cerebral palsySusan A Rethlefsen
Childrens Orthopaedic Center, Childrens Hospital Los Angeles, 4650 Sunset Boulevard, M S 69, Los Angeles, CA 90027, USA
J Bone Joint Surg Am 88:2175-80. 2006..The purpose of this study was to evaluate the prevalence of various causes of intoeing in children with cerebral palsy and to determine whether the causes differ between children with bilateral and those with unilateral involvement... - Quantitative CT reference values for vertebral trabecular bone density in children and young adultsVicente Gilsanz
Department of Radiology, Childrens Hospital Los Angeles, 4650 Sunset Blvd, MS 81, Los Angeles, CA 90027, USA
Radiology 250:222-7. 2009..To determine normative reference values for vertebral trabecular bone density (TBD) obtained by using quantitative computed tomography (CT) in healthy white children, teenagers, and young adults of both sexes... - Assessing bone mass in children and adolescentsTishya A L Wren
Childrens Hospital Los Angeles, Department of Radiology, MS 81, 4650 Sunset Boulevard, Los Angeles, CA 90027, USA
Curr Osteoporos Rep 4:153-8. 2006..Further research is needed to relate these measures to osteoporosis in the elderly and to short-term and long-term fracture risk... - Limitations of peripheral quantitative computed tomography metaphyseal bone density measurementsDavid C Lee
Department of Biomedical Engineering, University of Southern California, Los Angeles, California 90089, USA
J Clin Endocrinol Metab 92:4248-53. 2007..Large variations in bone morphology associated with skeletal development may limit the interpretation of pediatric pQCT studies based on a single slice... - Age at onset of puberty predicts bone mass in young adulthoodVicente Gilsanz
Children s Hospital Los Angeles, Department of Radiology, Los Angeles, CA 90027, USA
J Pediatr 158:100-5, 105.e1-2. 2011..To determine whether the commencement and length of puberty influences dual x-ray absorptiometry (DXA) values of bone mineral content (BMC) and bone mineral density (BMD) in the axial and appendicular skeleton at skeletal maturity... - Botulinum toxin as an adjunct to serial casting treatment in children with cerebral palsyRobert M Kay
Childrens Orthopaedic Center, MS #69 Children's Hospital Los Angeles, 4650 Sunset Boulevard, Los Angeles, CA 90027, USA
J Bone Joint Surg Am 86:2377-84. 2004.... - Outcome of gastrocnemius recession and tendo-achilles lengthening in ambulatory children with cerebral palsyRobert M Kay
Children's Orthopaedic Center, Children's Hospital Los Angeles, CA 90027, USA
J Pediatr Orthop B 13:92-8. 2004..Calf spasticity decreased and push-off power increased after GR. Both GR and TAL are effective in appropriately selected patients. However, a potential for over- and under-correction with both GR and TAL was demonstrated... - A simple method to obtain consistent and clinically meaningful pelvic angles from euler angles during gait analysisTishya A L Wren
Childrens Orthopaedic Center, Childrens Hospital Los Angeles, and the Department of Orthopaedics, University of Southern California, Los Angeles, CA, USA
J Appl Biomech 23:218-23. 2007..However, we suggest that exact clinical angles can and should be obtained through a few extra calculations as demonstrated in this technical note... - Assessment of bone acquisition in childhood and adolescenceVicente Gilsanz
Radiology Department, Childrens Hospital Los Angeles, Los Angeles, California 90027, USA
Pediatrics 119:S145-9. 2007.... - Reliability and validity of visual assessments of gait using a modified physician rating scale for crouch and foot contactTishya A L Wren
Children's Orthopaedic Center, Children's Hospital Los Angeles, Los Angeles, CA 90027, USA
J Pediatr Orthop 25:646-50. 2005..Visual assessment using the PRS does not appear to accurately measure what it is most commonly used to assess: ankle position in stance... - Three-point technique of fat quantification of muscle tissue as a marker of disease progression in Duchenne muscular dystrophy: preliminary studyTishya A L Wren
Department of Radiology, Children s Hospital Los Angeles, 4650 Sunset Blvd, MS 81, Los Angeles, CA 90027, USA
AJR Am J Roentgenol 190:W8-12. 2008..The purpose of this study was to examine whether muscle lipid infiltration measured with the three-point Dixon MRI technique has value as a marker of disease severity... - Normalizing lower extremity strength data for children, adolescents, and young adults with cerebral palsyTishya A L Wren
Childrens Orthopaedic Center, Childrens Hospital Los Angeles, Los Angeles, CA, USA
J Appl Biomech 25:195-202. 2009..For the first time, normalization equations have been presented with demonstrated effectiveness in adjusting strength measures for body size in a group of children, adolescents, and young adults with CP... - Reproducibility of carotid intima-media thickness measurements in young adultsJaime Gonzalez
Department of Radiology, Children s Hospital Los Angeles, MS No 81, 4650 Sunset Blvd, Los Angeles, CA 90027, USA
Radiology 247:465-71. 2008....
Research Grants
- Impact of Gait Analysis on Surgical OutcomesTishya Wren; Fiscal Year: 2007..The results will determine whether the use of gait analysis testing improves clinical outcomes in children who have walking problems due to cerebral palsy. ..
- Mechanical Intervention in Children with Cerebral PalsyTishya Wren; Fiscal Year: 2005..This study will also provide insight into the potential role of muscle adaptation and bone turnover in increasing bone mass in response to this simple, non-invasive, non-pharmacalogical intervention. ..
- Impact of Gait Analysis on Surgical OutcomesTishya Wren; Fiscal Year: 2009..The results will determine whether the use of gait analysis testing improves clinical outcomes in children who have walking problems due to cerebral palsy. ..
- Risk Factors for Osteoporosis in Children & Adolescents with MyelomeningoceleTishya A L Wren; Fiscal Year: 2010..A slight delay in the transition to wheelchair mobility may make a large difference in osteoporosis prevention. ..