Flexed-knee Gait in Children with Cerebral Palsy: a 10-year Follow-up Study

Overview

Journal J Child Orthop

Publisher Sage Publications

Specialty Pediatrics

Date 2014 Jan 17

PMID 24432107

Citations 5

Authors

Thierry Haumont

Chris Church

Shaun Hager

Maria Julia Cornes

Dijana Poljak

Nancy Lennon

John Henley

Daveda Taylor

Tim Niiler

Freeman Miller

Affiliations

Soon will be listed here.

Abstract

Background: While several studies have evaluated the short-term effectiveness of conservative and surgical treatment of flexed-knee gait in children with cerebral palsy (CP), few have explored the long-term outcomes using gait analysis. The purpose of this study was to examine, through gait analysis, the 10-year outcomes of flexed-knee gait in children with CP.

Methods: Ninety-seven children with spastic CP who walked with a flexed-knee gait underwent two gait evaluations [age 6.1 ± 2.1 and 16.2 ± 2.3 years, Gross Motor Function Classification System (GMFCS) I (12), II (45), III (37), IV (3)]. Limbs with knee flexion at initial contact >15° were considered walking with a flexed-knee gait and were included in the study (n = 185). Kinematic data were collected using an eight-camera motion analysis system (Motion Analysis, Santa Rosa, CA). Surgical and therapeutic interventions were not controlled.

Results: A comparison between the two gait studies showed an overall improvement in gait at 10 years follow-up. Significant improvements were seen in knee flexion at initial contact, Gait Deviation Index (GDI), Gross Motor Function Measure (GMFM), and gait speed (P < 0.01 for all). Outcome was also evaluated based on the severity of flexed-knee gait at the initial visit, with functional skills and overall gait (GDI) improving in all groups (P < 0.01 for all). The group with a severe flexed-knee gait exhibited the most improvement, while subjects with a mild flexed-knee improved the least.

Conclusions: Children at a specialty hospital whose orthopedic care included gait analysis and multi-level surgery showed improvement of flexed-knee gait and gross motor function over a 10-year course, regardless of the initial severity.

Citing Articles

Kinematic Changes throughout Childhood in Youth with Cerebral Palsy: Influence of Age and Orthopaedic Surgery.

Lennon N, Church C, Wagner D, Niiler T, Henley J, Miller F Children (Basel). 2024; 11(10).

PMID: 39457205 PMC: 11505677. DOI: 10.3390/children11101240.

Feasibility and usefulness of video-based markerless two-dimensional automated gait analysis, in providing objective quantification of gait and complementing the evaluation of gait in children with cerebral palsy.

Pantzar-Castilla E, Balta D, Croce U, Cereatti A, Riad J BMC Musculoskelet Disord. 2024; 25(1):747.

PMID: 39289680 PMC: 11406781. DOI: 10.1186/s12891-024-07853-9.

Patient-reported mobility function and engagement in young adults with cerebral palsy: a cross-sectional sample.

Lennon N, Church C, Miller F J Child Orthop. 2018; 12(2):197-203.

PMID: 29707060 PMC: 5902755. DOI: 10.1302/1863-2548.12.170127.

Factors influencing outcomes after medial hamstring lengthening with semitendinosus transfer in patients with cerebral palsy.

Sung K, Lee J, Chung C, Lee K, Cho B, Moon S J Neuroeng Rehabil. 2017; 14(1):83.

PMID: 28806980 PMC: 5556982. DOI: 10.1186/s12984-017-0296-0.

Effectiveness of surgical and non-surgical management of crouch gait in cerebral palsy: A systematic review.

Galey S, Lerner Z, Bulea T, Zimbler S, Damiano D Gait Posture. 2017; 54:93-105.

PMID: 28279852 PMC: 9619302. DOI: 10.1016/j.gaitpost.2017.02.024.

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