Gait analysis in children with cerebral palsy

Abstract

Cerebral palsy (CP) children present complex and heterogeneous motor disorders that cause gait deviations.Clinical gait analysis (CGA) is needed to identify, understand and support the management of gait deviations in CP. CGA assesses a large amount of quantitative data concerning patients' gait characteristics, such as video, kinematics, kinetics, electromyography and plantar pressure data.Common gait deviations in CP can be grouped into the gait patterns of spastic hemiplegia (drop foot, equinus with different knee positions) and spastic diplegia (true equinus, jump, apparent equinus and crouch) to facilitate communication. However, gait deviations in CP tend to be a continuum of deviations rather than well delineated groups. To interpret CGA, it is necessary to link gait deviations to clinical impairments and to distinguish primary gait deviations from compensatory strategies.CGA does not tell us how to treat a CP patient, but can provide objective identification of gait deviations and further the understanding of gait deviations. Numerous treatment options are available to manage gait deviations in CP. Generally, treatments strive to limit secondary deformations, re-establish the lever arm function and preserve muscle strength.Additional roles of CGA are to better understand the effects of treatments on gait deviations. Cite this article: Armand S, Decoulon G, Bonnefoy-Mazure A. Gait analysis in children with cerebral palsy. EFORT Open Rev 2016;1:448-460. DOI: 10.1302/2058-5241.1.000052.

Keywords: cerebral palsy; clinical gait analysis; gait deviations.

Fig. 1

Example of data in clinical gait analysis report for bilateral spastic cerebral palsy (video stills).

Fig. 2

Example of data in clinical gait analysis report for bilateral spastic cerebral palsy: spatiotemporal parameters.

Fig. 3

Example of data in clinical gait analysis report for bilateral spastic cerebral palsy: kinematics.

Fig. 4

Example of data in clinical gait analysis report for bilateral spastic cerebral palsy: kinetics.

Fig. 5

Example of data in clinical gait analysis report for bilateral spastic cerebral palsy: gait scores.

Fig. 6

Example of data in clinical gait analysis report for bilateral spastic cerebral palsy: electromyography.

Fig. 7

Example of data in clinical gait analysis report for bilateral spastic cerebral palsy: plantar pressures.

Fig. 8

Gait patterns and management algorithm for unilateral spastic cerebral palsy. Republished from European Journal of Neurology with kind permission of John Wiley and Sons. Original publication: Rodda J, Graham HK. Classification of gait patterns in spastic hemiplegia and spastic diplegia: a basis for a management algorithm. Eur J Neurol 2001;8(suppl 5):98-108.

Fig. 9

Gait patterns and management algorithm for bilateral spastic cerebral palsy. Republished from European Journal of Neurology with kind permission of John Wiley and Sons. Original publication: Rodda J, Graham HK. Classification of gait patterns in spastic hemiplegia and spastic diplegia: a basis for a management algorithm. Eur J Neurol 2001;8(suppl 5):98-108.