What can we learn from the relationship between gait deviations and clinical impairments when comparing two databases?

Annie Pouliot-Laforte; Louise Iterbeke; Anne Tabard-Fougère; Alice Bonnefoy-Mazure; Geraldo De Coulon; Kaat Desloovere; Stéphane Armand

doi:10.1016/j.gaitpost.2022.09.072

What can we learn from the relationship between gait deviations and clinical impairments when comparing two databases?

Gait Posture. 2022 Oct:98:261-265. doi: 10.1016/j.gaitpost.2022.09.072. Epub 2022 Sep 15.

Authors

Annie Pouliot-Laforte¹, Louise Iterbeke², Anne Tabard-Fougère³, Alice Bonnefoy-Mazure³, Geraldo De Coulon⁴, Kaat Desloovere⁵, Stéphane Armand³

Affiliations

¹ Kinesiology Laboratory, Geneva University Hospitals and University of Geneva, Geneva, Switzerland. Electronic address: annie.pouliot@unige.ch.
² Kinesiology Laboratory, Geneva University Hospitals and University of Geneva, Geneva, Switzerland; Department of Rehabilitation Sciences, Katholieke Universiteit Leuven, Leuven, Belgium; Clinical Motion Analysis Laboratory Pellenberg, University Hospital Leuven, Leuven, Belgium.
³ Kinesiology Laboratory, Geneva University Hospitals and University of Geneva, Geneva, Switzerland.
⁴ Pediatric Orthopedic Service, Department of Child and Adolescent, Geneva University Hospitals, Geneva, Switzerland.
⁵ Department of Rehabilitation Sciences, Katholieke Universiteit Leuven, Leuven, Belgium; Clinical Motion Analysis Laboratory Pellenberg, University Hospital Leuven, Leuven, Belgium.

PMID: 36209688
DOI: 10.1016/j.gaitpost.2022.09.072

Abstract

Background: Several previous studies have tried to determine the relationship between gait and clinical impairments in children with Cerebral Palsy (CP). The heterogeneity of the population and the methodology used could explain the discrepancy within the results. Recently, Papageorgiou et al. (2019) used a Statistical Parametric Mapping (SPM) analysis to investigate this relationship, allowing to test across the kinematic waveforms parameters.

Research question: Are we able to replicate the results of Papageorgiou et al. (2019) on a population of children with CP from another center?

Methods: Retrospectively, youth with spastic unilateral (uCP) or bilateral (bCP) CP (3-18 years of age) who underwent a clinical gait analysis at the Geneva University Hospitals (HUG) were screened. Following Papageorgiou et al. 2019, the same inclusion and exclusion criteria as well as the same methodology were applied. Mann-Whitney-U test was used to compare the impairments score between the two centers. A Student T-Test using SPM was applied to compare the kinematic waveforms from the two centers. A canonical correlation analysis using SPM was realized to assess the relationship between clinical impairments and the combined sagittal motion of the pelvis, hip, knee and ankle.

Results and significance: A total of 211 patients were included with 131 uCP (10 [8-14] years old) and 80 bCP (11 [7-14] years old). The distribution of the Gross Motor Function Classification System levels and the proportion of previous treatment differs between centers. In both CP groups, significant differences were observed in the composite score and lower limb kinematics, reflecting less impaired patients with CP at HUG compared to Papagergiou et al. (2019). While similar associations between spasticity and kinematic were observed in both centers, the association with muscle weakness, selectivity, and range of motion differed.

Keywords: Cerebral palsy; Clinical examination; Gait analysis; Joint motions.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Biomechanical Phenomena
Cerebral Palsy* / complications
Child
Gait Analysis / methods
Gait* / physiology
Humans
Muscle Spasticity
Retrospective Studies