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Updated: Aug 7, 2026
Clinical-oriented Three-dimensional Gait Analysis Method for Evaluating Gait Disorder
Published on: March 4, 2018
Factors associated with internal hip rotation gait in patients with cerebral palsy
Rory O'Sullivan1, Michael Walsh, Penny Hewart
1Gait Laboratory, Central Remedial Clinic, Dublin, Ireland. rosullivan@crc.ie
Insights
Internal rotation gait in cerebral palsy is common and multifactorial. Key contributing factors include limited external rotation, femoral anteversion, and hip flexor contracture, guiding treatment strategies.
Area of Science:
- Orthopedics
- Pediatric Neurology
- Movement Science
Background:
- Internal rotation gait is a prevalent characteristic in children with cerebral palsy.
- Contributing factors are believed to include femoral anteversion, hip rotator imbalance, and hamstring/adductor tightness.
Purpose of the Study:
- To investigate the prevalence of internal hip rotation in cerebral palsy patients.
- To identify associated clinical factors influencing this gait pattern.
Main Methods:
- Retrospective analysis of gait laboratory data from 222 cerebral palsy patients.
- Group comparison based on maximum dynamic hip internal rotation ( >27° vs. <20°).
Main Results:
- 27.0% of patients exhibited dynamic hip internal rotation exceeding 27 degrees.
- Significant differences observed in passive hip external rotation range, femoral anteversion, and hip flexor contracture between groups.
Conclusions:
- Dynamic hip internal rotation in cerebral palsy is multifactorial.
- Early intervention for hip flexion contracture may be beneficial.
- Understanding specific contributing factors is crucial for surgical considerations.
Abstract:
Internal rotation gait is common in children with cerebral palsy. Factors thought to contribute include femoral anteversion, hip flexor tightness, imbalance of hip rotators, and hamstring and adductor tightness. The exact cause of internal rotation must be defined before contemplating surgery. We investigated the prevalence of internal hip rotation and associated factors, which are considered to influence this walking pattern, in patients with cerebral palsy. Gait laboratory data of 222 patients with cerebral palsy were studied retrospectively. Two groups were selected; those with maximum dynamic hip internal rotation of more than 27 degrees and those with less than 20 degrees. Of 222 patients, 27.0% (diplegia, 61.7%; hemiplegia, 38.3%) had at least one hip with dynamic internal rotation of more than 27 degrees. This study suggests that dynamic hip internal rotation is multifactorial in origin. The most significant differences in clinical measures were found in values of passive hip external rotation range, femoral anteversion and hip flexor contracture. We discuss the role of early treatment of hip flexion contracture.
