Clinical and Gait Parameters Related to Pelvic Retraction in Patients with Spastic Hemiplegia

Abstract

Pelvic retraction during walking is a common finding seen in patients with spastic hemiplegia. However, potential factors related to this condition have not been comprehensively examined in a systemic manner in previous studies. The purpose of this study was to elucidate any clinical and gait parameters related to pelvic retraction in patients with hemiplegic cerebral palsy. A total of 212 independent ambulatory patients were enrolled in the study. Group I consisted of 113 patients who had persistent pelvic retraction, and Group II of 99 with a normal range of pelvic rotation throughout the gait cycle as evidenced by kinematic analysis. A multivariate logistic regression analysis using a clustering technique was performed, with use of eight gait factors and five clinical factors. Decreased ankle dorsiflexion, increased hip internal rotation, increased anterior pelvic tilt, the Winters classification type II, and asymmetrical posturing of the upper extremity during gait were found to be related to pelvic retraction. This is the only study including a broader array of assessment domains of both clinical and gait parameters with a considerably large and homogenous population with hemiplegia. Further studies will be needed to see whether the rectification of those parameters may improve abnormal gait and pelvic retraction in hemiplegia.

The Variable Influence of Orthotic Management on Hip and Pelvic Rotation in Children with Unilateral Neurogenic Equinus Deformity

“…However, this correction of pes equinus showed variable effects on hip and pelvic rotation, even though pes equinus has been associated with pelvic retraction and internal hip rotation in the previous literature [10,27]. From this global evaluation, the clinical relevance of these effects seems only to be relevant for some children, or other factors mask…”

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

“…Very few specific clinical examination measures correlated with gait deviations, eg, mid-point of hip rotation with dynamic hip rotation, r = .57 84. Most routine clinical examination measures either demonstrated weak relationships or did not correlate with dynamic gait measures 85,97,99-113…”

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Predictors of Changes in Pelvic Rotation after Surgery with or without Femoral Derotational Osteotomy in Ambulatory Children with Cerebral Palsy

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