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. 2023 Mar 6;17(2):173-183.
doi: 10.1177/18632521231154975. eCollection 2023 Apr.

A 10.5-year follow-up of walking with unilateral spastic cerebral palsy

Alice Bonnefoy-Mazure  1 , Geraldo De Coulon  2 , Pierre Lascombes  3 , Aline Bregou  4 , Stéphane Armand  1
Affiliations

A 10.5-year follow-up of walking with unilateral spastic cerebral palsy

Alice Bonnefoy-Mazure et al. J Child Orthop. .

Abstract

Purpose: The purpose of this study was to describe gait evolution in patients with unilateral spastic cerebral palsy (USCP) using modified Gait Profile Score (mGPS without hip rotation), Gait Variable Score (GVS), walking speed, and the observed effects of single-level surgery (SLS) after 10 years.

Methods: Fifty-two patients with USCP (Gross Motor Function Classification System I) and data from two Clinical Gait Analyses (CGAs) were included. The evolution of patients' mGPS, GVS, and walking speed were calculated. Two "no surgery" and "single-level surgery" patient categories were analyzed. Paired t-tests were used to compare the data between CGAs and as a function of treatment category. Pearson's correlations were used to examine relationships between baseline values and evolutions in mGPS and walking speed.

Results: Mean ages (SD) at first and last CGAs were 9.3 (3.2) and 19.7 (6.0) years old, respectively, with an average follow-up of 10.5 (5.6) years. Mean mGPS for the patients' affected side was significantly lower at the last CGA for the full cohort: baseline = 8.5° (2.1) versus follow-up = 7.2° (1.6), effect size = 0.73, p < 0.001. Significant improvements in mGPS and GVS for ankle and foot progression were found for the SLS group. The mGPS change and mGPS at baseline (r = -0.79, p < 0.001) were negatively correlated.

Conclusions: SLS patients demonstrated a positive long-term change in gait pattern over time. The group that had undergone surgery had worse gait scores at baseline than the group that had not, but the SLS group's last CGA scores were relatively closer to those of the "no surgery" group.

Level of evidence: This was a retrospective comparative therapeutic study (level III).

Keywords: Clinical gait analysis; long-term follow-up; single-level surgery; unilateral spastic cerebral palsy.

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Conflict of interest statement

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Flow chart of patients with cerebral palsy (CP) as a function of inclusion and exclusion criteria. Definition of three groups as a function of their treatment: no surgery and single-level surgery (SLS). GMFCS: Gross Motor Function Classification System; CGA: clinical gait analysis.
Figure 2.
Figure 2.
Boxplot for the modified GPS between the “no surgery” patient group and the “single-level surgery” patient group for each clinical gait analysis (first and last CGA).
See this image and copyright information in PMC

References

    1. Kulak W, Sobaniec W. Comparisons of right and left hemiparetic cerebral palsy. Pediatr Neurol 2004; 31(2): 101–108. - PubMed
    1. Bax M, Goldstein M, Rosenbaum P, et al.. Proposed definition and classification of cerebral palsy, April 2005. Dev Med Child Neurol 2005; 47(8): 571–576. - PubMed
    1. Wren TA, Rethlefsen S, Kay RM. Prevalence of specific gait abnormalities in children with cerebral palsy: influence of cerebral palsy subtype, age, and previous surgery. J Pediatr Orthop 2005; 25(1): 79–83. - PubMed
    1. Romkes J, Hell AK, Brunner R. Changes in muscle activity in children with hemiplegic cerebral palsy while walking with and without ankle-foot orthoses. Gait Posture 2006; 24(4): 467–474. - PubMed
    1. Skaaret I, Steen H, Huse AB, et al.. Comparison of gait with and without ankle-foot orthoses after lower limb surgery in children with unilateral cerebral palsy. J Children Orthop 2019; 13(2): 180–189. - PMC - PubMed

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