Kinematic Gait Analysis in Children with Spastic Diplegic Cerebral Palsy after Selective Posterior Rhizotomy: Long Term Follow Up

OBJECTIVE: To evaluate the changes of kinematic gait patterns at long-term follow up study after selective posterior rhizotomy (SPR) in children with spastic diplegic cerebral palsy. METHOD: Eighteen children with spastic diplegic cerebral palsy participated in this study. Gait patterns on sagittal plane were studied before and at average 3.5 years after SPR. Kinematic and temporospatial data were obtained by the VICON 370 system. RESULTS: The spasticity of hip adductor and ankle plantar flexor were improved significantly after SPR. The maximal angle of pelvic tilt, ankle dorsiflexion angle at initial contact, peak ankle dorsiflexion angle during stance phase, at toe-off and during swing phase, mid-range point of flexion-extension motion on ankle were significantly improved after SPR. The temporospatial data tended to improve after SPR at long-term follow up. CONCLUSION: The SPR reduced spasticity and the gait pat terns were improved in children with spastic diplegic cere bral palsy at long-term follow up.

Kinematic Gait Analysis in Children with Hemiplegic Spastic Cerebral Palsy

OBJECTIVE: The purpose of this study is to evaluate gait characteristics using kinematic analysis in children with hemiplegic spastic cerebral palsy. METHOD: Fifty-seven non-operated spastic hemiplegic children who were able to walk independently without any walking aid were recruited as subjects. Three-dimensional kinematic gait analysis using a motion analyzer (Vicon 370 M. A. with 6 infrared cameras) were performed in all patients. Changes in joint angle of hip, knee and ankle in sagittal plane were evaluated to classify gait pattern and also the temporospatial values were measured to determine any differences between groups. RESULTS: Gait patterns were able to be classified into 6 groups. Group I had a minimal gait disturbance, a drop foot pattern. Group II showed hip and knee flexed, with normal ankle range. Group III showed hip, knee, and ankle flexed. Group IV showed genu recurvatum with tibia progression, Group V showed genu recurvatum with tibia arrest. Group VI showed stiff crouch gait. However, the temporospatial values between groups were not significantly different. CONCLUSION: This classification system would be useful for converting the vast quantitative information of gait analysis into descriptive and clinically relevant patterns. Therefore, it would be helpful for the clinician to understand underlying pathology and plan appropriate treatment.