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Published on: January 15, 2016
Gait patterns in children with spastic diplegia and periventricular leukomalacia
1Department of Rehabilitation, Ohzora Hospital, 7448 Nakagawa, Hosoe, Inasa, 431-1304, Shizuoka, Japan. yokochi@orange.ne.jp
Insights
This study tracked gait changes in children with spastic diplegia and periventricular leukomalacia (PVL). Gait patterns evolved, with knee flexion and varied ankle movements common throughout development.
Area of Science:
- Neurology
- Pediatrics
- Biomechanical Engineering
Background:
- Spastic diplegia, often associated with periventricular leukomalacia (PVL), significantly impacts motor development in children.
- Understanding the evolution of gait patterns in these children is crucial for targeted interventions.
Purpose of the Study:
- To retrospectively analyze sequential changes in gait patterns of children with spastic diplegia and PVL.
- To document the progression of specific gait characteristics from initial walking to adolescence.
Main Methods:
- Retrospective analysis of videotape recordings of 20 children diagnosed with spastic diplegia and PVL.
- Gait analysis focused on hip, knee, and ankle kinematics during the stance phase.
- Subjects were observed from their initial walking phase (1-5 years) to 6-16 years of age.
Main Results:
- Most children exhibited hip, knee, and ankle flexion during walking.
- Persistent knee flexion during stance was observed in all cases by the final examination.
- Significant variability in ankle dorsiflexion and plantarflexion was noted, with some initial over-extension and recurvatum knee resolving over time.
Conclusions:
- Gait patterns in children with spastic diplegia and PVL are dynamic and undergo sequential changes.
- While some initial deviations like knee recurvatum may resolve, persistent knee flexion and variable ankle movements characterize the gait.
- The findings highlight the complex and evolving nature of motor control deficits in this population.
Abstract:
Sequential changes in gait patterns were investigated retrospectively by analyzing the videotape recordings of 20 children with spastic diplegia and periventricular leukomalacia (PVL). The subjects began to walk at 1-5 years of age, and their walking was examined to 6-16 years of age. Many of the ambulatory children with spastic diplegia walked with flexed hips, knees and ankles. At the final walking examination, the knee was flexed during the stance phase in both legs and in all cases. In addition, the ankle was over-plantarflexed during the stance phase in nine cases or 14 legs, and dorsiflexed in 15 cases or 26 legs. At the initial walking, the knee was over-extended during the stance phase in seven cases or 12 legs, and was flexed in 15 cases or 28 legs. Also, the ankle was over-plantarflexed during the stance phase in 14 cases or 22 legs, and dorsiflexed in ten cases or 18 legs. Bilateral excessive ankle plantarflexion or a recurvatum knee was observed in a portion of the children at the initial phase of walking only. In the diplegic children with PVL, the gait pattern was variable.
