Most frequent gait patterns in diplegic spastic cerebral palsy

Abstract

OBJECTIVE: To identify gait patterns in a large group of children with diplegic cerebral palsy and to characterize each group according to age, Gross Motor Function Classification System (GMFCS) level, Gait Deviation Index (GDI) and previous surgical procedures. METHODS: One thousand eight hundred and five patients were divided in seven groups regarding observed gait patterns: jump knee, crouch knee, recurvatum knee, stiff knee, asymmetric, mixed and non-classified. RESULTS: The asymmetric group was the most prevalent (48.8%). The jump knee (9.6 years old) and recurvatum (9.4 years old) groups had mean age lower than the other groups. The lowest GDI (43.58) was found in the crouch group. There were more children classified within GMFCS level III in the crouch and mixed groups. Previous surgical procedures on the triceps surae were more frequent in stiff knee and mixed groups. The jump knee group received less and the stiff-knee group more surgical procedures at hamstrings than others. CONCLUSIONS: The asymmetrical cases were the most frequent within a group of diplegic patients. Individuals with crouch gait pattern were characterized by the lowest GDI and the highest prevalence of GMFCS III, while patients with stiff knee exhibited a higher percentage of previous hamstring lengthening in comparison to the other groups. Level of Evidence III, Retrospective Comparative Study.

Prevalence of Joint Gait Patterns Defined by a Delphi Consensus Study Is Related to Gross Motor Function, Topographical Classification, Weakness, and Spasticity, in Children with Cerebral Palsy

“…The prevalence of “minor gait deviations” reached more than 50% for the hip across the three anatomical planes, the pelvis in the coronal plane, and the foot progression angle. The need to define a pattern showing mild gait pathology has also been reported before, for example for the classifications of Winters et al (1987) (hemiplegic patterns) and Rodda et al (2004) (diplegic patterns) (Riad et al, 2007; McDowell et al, 2008; de Morais Filho et al, 2014). In both population- and hospital-based recruitment settings, the prevalence of these mild patterns has been reported to range between 12–43% (McDowell et al, 2008; de Morais Filho et al, 2014).…”

“…The need to define a pattern showing mild gait pathology has also been reported before, for example for the classifications of Winters et al (1987) (hemiplegic patterns) and Rodda et al (2004) (diplegic patterns) (Riad et al, 2007; McDowell et al, 2008; de Morais Filho et al, 2014). In both population- and hospital-based recruitment settings, the prevalence of these mild patterns has been reported to range between 12–43% (McDowell et al, 2008; de Morais Filho et al, 2014). The numbers in this study are generally higher, but this may be explained by the fact that the gait patterns in this study were evaluated at joint level, in contrast to the previous studies where total gait patterns, including multiple joints, have been reported.…”

Correlation between the selective control assessment of lower extremity and pediatric balance scale scores in children with spastic cerebral palsy

“…In a previous study, the SCALE hip test was performed for participants with spastic CP showing crouch gait in an antigravity side-lying position 17 ) . In this position, it was difficult for the participants to raise their hip joints due to muscle weakness, and thus they had limitations of hip extension because of hamstring shortness.…”

Surgical treatment options for spastic movement disorders of the extremities

“…Das Gangbild wird auch wesentlich durch eine zentrale Störung der Balance und Koordination beeinflusst. Verschiedene Gangarten werden sowohl bei beidseitiger als auch einseitiger Spastik beschrieben [15,16]. Das häufigste Gangbild bei bilateraler Spastik ist der Kauergang und bei unilateraler der Spitzfußgang.…”