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Hip locomotion mechanisms in cerebral palsy crouch gait
G Steinwender1, V Saraph, E B Zwick
1Department of Paediatric Orthopaedics, Karl Franzens University, Auenbrugerplatz 34, A-8036 Graz, Austria. gerhardt.steinwender@kfunigraz.ac.at
Insights
Children with cerebral palsy (cerebral palsy) exhibit altered hip muscle function and increased hip internal rotation during gait. These gait deviations, including pseudo-adduction, are evident even without crouch gait.
Area of Science:
- Biomechanics
- Pediatric Orthopedics
- Neurology
Background:
- Cerebral palsy (cerebral palsy) significantly impacts motor function, affecting gait patterns in affected children.
- Understanding specific gait deviations is crucial for targeted interventions and improving mobility.
Purpose of the Study:
- To analyze and compare locomotion patterns in children with cerebral palsy (cerebral palsy) and a control group using advanced gait analysis.
- To investigate the hip hike, hip extensor function, and pseudo-adduction in diplegic children with and without crouch gait.
Main Methods:
- Computerized gait analysis was employed to assess ambulatory diplegic children (no prior surgery) and age-matched normal children.
- Participants were categorized into groups based on the presence or absence of crouch gait.
- Specific gait parameters including hip hike, hip extensor power generation, and hip rotation/adduction were statistically analyzed.
Main Results:
- The hip hike mechanism was not utilized by any study group.
- Diplegic children demonstrated earlier hip power generation during the gait cycle compared to normal children.
- Increased hip internal rotation was observed in diplegic children during the first half of stance, while hip adduction degrees were similar across all groups, confirming pseudo-adduction.
Conclusions:
- Diplegic children exhibit altered hip muscle function and increased internal rotation, contributing to pseudo-adduction.
- These gait alterations are present regardless of the presence of crouch gait, highlighting underlying neuromuscular differences.
Abstract:
The purpose of this study was to evaluate three defined locomotion patterns in cerebral palsy gait using computerised gait analysis. Ambulant diplegic children who had no previous surgery were included in the study and were divided into two groups: one group consisted of children having a crouch gait, and the other group did not have the crouch pattern of gait. An age-matched group of normal children served as the control group. Locomotion patterns studied were the hip hike, propulsive function of the hip extensors, and pseudo-adduction. A statistical analysis was performed between the groups, using defined parameters. The mechanism of hip hike was not utilised by any of the groups. Both groups of diplegic children showed power generation at the hip beginning in the first double support phase of the gait cycle and continuing in the first half of single limb support, while in the normals this was only in the first half of single limb support. Both the groups of diplegic children showed significantly more internal rotation in the first half of stance as compared to the group of normal children; the degree of hip adduction was the same in all the groups. Thus diplegic children had pseudo-adduction.