The relationship between clinical measurements and gait analysis data in children with cerebral palsy

Gait Posture. 2013 Sep;38(4):1038-43. doi: 10.1016/j.gaitpost.2013.05.031. Epub 2013 Jun 28.

Abstract

Spasticity is a common impairment that interferes with motor function (particularly gait pattern) in children with cerebral palsy (CP). Gait analysis and clinical measurements are equally important in evaluating and treating gait disorders in children with CP. This study aimed to explore the relationship between the spasticity of lower extremity muscles and deviations from the normal gait pattern in children with CP. Thirty-six children with spastic CP (18 with spastic hemiplegia [HS] and 18 with spastic diplegia [DS]), ranging in age from 7 to 12 years, participated in the study. The children were classified as level I (n=24) or level II (n=12) according to the Gross Motor Function Classification System. Spasticity levels were evaluated with the Dynamic Evaluation of Range of Motion (DAROM) using the accelerometer-based system, and gait patterns were evaluated with a three dimensional gait analysis using the Zebris system (Isny, Germany). The Gillette Gait Index (GGI) was calculated from the gait data. The results show that gait pathology in children with CP does not depend on the static and dynamic contractures of hip and knee flexors. Although significant correlations were observed for a few clinical measures with the gait data (GGI), the correlation coefficients were low. Only the spasticity of rectus femoris showed a fair to moderate correlation with GGI. In conclusion, the results indicate the independence of the clinical evaluation and gait pattern and support the view that both factors provide important information about the functional problems of children with CP.

Keywords: Accelerometer; Cerebral Palsy; Clinical assessment of spasticity; Gait; Gillette Gait Index.

MeSH terms

  • Biomechanical Phenomena
  • Cerebral Palsy / complications
  • Cerebral Palsy / physiopathology*
  • Child
  • Female
  • Foot Joints / physiopathology
  • Gait Disorders, Neurologic / etiology
  • Gait Disorders, Neurologic / physiopathology*
  • Hemiplegia / complications
  • Hemiplegia / physiopathology*
  • Hip Joint / physiopathology
  • Humans
  • Knee Joint / physiopathology
  • Leg / physiopathology*
  • Male
  • Muscle Spasticity / etiology
  • Muscle Spasticity / physiopathology*
  • Muscle, Skeletal / physiopathology*
  • Physical Examination
  • Range of Motion, Articular / physiology

Supplementary concepts

  • Cerebral palsy, spastic, diplegic