Correlation between physical examination and three-dimensional gait analysis in the assessment of rotational abnormalities in children with cerebral palsy

Abstract

ObjectiveTo evaluate the correlation between physical examination data concerning hip rotation and tibial torsion with transverse plane kinematics in children with cerebral palsy; and to determine which time points and events of the gait cycle present higher correlation with physical examination findings.MethodsA total of 195 children with cerebral palsy seen at two gait laboratories from 2008 and 2016 were included in this study. Physical examination measurements included internal hip rotation, external hip rotation, mid-point hip rotation and the transmalleolar axis angle. Six kinematic parameters were selected for each segment to assess hip rotation and shank-based foot rotation. Correlations between physical examination and kinematic measures were analyzed by Spearman correlation coefficients, and a significance level of 5% was considered.ResultsComparing physical examination measurements of hip rotation and hip kinematics, we found moderate to strong correlations for all variables (p<0.001). The highest coefficients were seen between the mid-point hip rotation on physical examination and hip rotation kinematics (rho range: 0.48-0.61). Moderate correlations were also found between the transmalleolar axis angle measurement on physical examination and foot rotation kinematics (rho range 0.44-0.56; p<0.001).ConclusionThese findings may have clinical implications in the assessment and management of transverse plane gait deviations in children with cerebral palsy.

Assessment of lower limbs in people with Generalized Joint Hypermobility (GJH) - preliminary report

“…Researcher #1 controlled and stabilized the participant's pelvis. Researcher #2 measured the passive range of motion of internal and external rotation of the hip by placing the axis of rotation of the goniometer within the knee, and the fixed arm was parallel to the ground, and mobile along the calf [16][17][18]. b. the tibial torsion.…”

Three-Dimensional Instrumented Gait Analysis for Children With Cerebral Palsy: An Evidence-Based Clinical Practice Guideline

“…Thirty-three studies demonstrate that 3D-IGA provides body structure and function information that is unique and complementary to clinical examinations and that may differentiate key determinates of atypical gait patterns. Among numerous clinical examination and 3D-IGA measures, few resulted in strong correlations,29,82-98 suggesting that clinical examinations and 3D-IGA data quantify different aspects of a child’s presentation. Very few specific clinical examination measures correlated with gait deviations, eg, mid-point of hip rotation with dynamic hip rotation, r = .57 84.…”