Courtney Lange

Kathleen Lange had twins prematurely by cesarean section. The baby girl had gone into fetal distress when her twin brother was lying on her umbilical cord, depriving her brain of oxygen for precious minutes.

When the baby girl, Courtney, was less than one year old, Lange noticed she wasn't sitting up like her brother, Tanner, was. Physicians at Mayo Clinic, where Lange works, determined through testing that Courtney has cerebral palsy, a group of disorders characterized by loss of movement or nerve functions. It is caused by abnormal brain development that occurs before birth, or injuries to the brain at the time of birth or within the first three years of life.

"We were devastated when we learned something was wrong with Courtney," says Lange. "But her case is mild; we know it could be much worse. My husband, Wayne, and I have handled it by always encouraging Courtney and telling her she can try to do whatever Tanner can. She has never let cerebral palsy hold her back from trying anything."

Courtney began physical therapy immediately and continues today. When she was 6, she had a dorsal rhizotomy, or surgery on her back to cut some of the nerve fibers and relieve spasticity, or tightening, in her heel cords. Before the surgery, Courtney walked on her tiptoes.

The Langes saw William Shaughnessy, M.D., a Mayo Clinic orthopedic surgeon, for evaluation of Courtney's left leg, which was twisted inward from hip to foot — a condition that had worsened as she grew older. Dr. Shaughnessy suggested Courtney be evaluated at the Mayo Clinic Motion Analysis Lab.

"Most musculoskeletal tests — X-ray, CT scan and MRI — evaluate the patient while he or she is lying down or standing," says Dr. Shaughnessy. "That doesn't tell us how the person performs during activities of daily living. The Motion Analysis Lab measures the patient's function while he or she is moving, which provides physicians and other healthcare providers with important information to aid in developing treatment plans."

Courtney, now 10, is a veteran of the Motion Analysis Lab, having had her flexibility, range of motion, strength, walking and balance evaluated numerous times. When her left side was determined to be weaker than her right due to the inward turning, Courtney's physical therapy was adjusted to work on strengthening the leg and improving her gait.

"When we see exactly how Courtney is doing at various stages of life, from the top of her head down to her little toe, we can prescribe physical therapy in the form of muscle training, exercises and stretches specific to her needs and designed to help her continue to keep up with her twin brother," says Dr. Shaughnessy.

The Langes are grateful for the child-centered, compassionate care they've received at Mayo Clinic. "We couldn't have had a better physician than Dr. Shaughnessy," says Kathleen Lange. "When you look at Courtney, it is much harder to notice she has cerebral palsy because of the surgery and treatment she has had. She is walking better, loves to swim and has a special three-wheel bike. We emphasize her strengths with her rather than her limitations. She's a typical, outgoing, determined, affectionate girl. She'll get through this with the support of her family and friends, and the fact that she wants to be just like everyone else. And her healthcare team has that very same goal for her."