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Updated: Jul 6, 2026
Clinical-oriented Three-dimensional Gait Analysis Method for Evaluating Gait Disorder
Published on: March 4, 2018
The validity of an existing gait classification system when applied to a representative population of children with
Brona C McDowell1, Claire Kerr, Connor Kelly
1Gait Analysis Service, Musgrave Park Hospital, Belfast BT9 7JB, Ireland. brona.mcdowell@belfasttrust.hscni.net
Insights
This study analyzed gait patterns in children with hemiplegic cerebral palsy (CP), finding most exhibit minor deviations. The Winters
Area of Science:
- Orthopedics and Sports Medicine
- Pediatric Neurology
- Rehabilitation Science
Background:
- Hemiplegic cerebral palsy (CP) significantly impacts motor function, particularly gait.
- Understanding sagittal plane gait patterns is crucial for effective intervention in children with CP.
- Existing classification systems may not fully capture the diversity of gait deviations in this population.
Purpose of the Study:
- To describe sagittal plane gait patterns in children with hemiplegic cerebral palsy (CP).
- To evaluate the utility of Winters' Classification system in categorizing CP gait deviations.
- To identify potential areas for refinement in gait analysis for children with CP.
Main Methods:
- Ninety-one children with hemiplegic CP (age 5-18) and 49 typically developing children underwent kinematic data capture.
- Gait data was analyzed using an algorithm based on Winters' Classification system.
- Children were categorized into specific gait types based on sagittal plane kinematics.
Main Results:
- The majority of children with hemiplegic CP were classified into Groups I and II, indicating relatively minor gait deviations.
- A significant portion of children with hemiplegic CP (42%) were not classified by the current system.
- The Winters' classification demonstrated ability to differentiate hemiplegic CP gait from unimpaired gait.
Conclusions:
- The Winters' Classification system can distinguish hemiplegic CP gait but may not fully capture all deviations.
- Most children with hemiplegic CP present with mild sagittal plane gait abnormalities.
- Further refinement of sagittal plane ankle joint kinematics analysis is needed for unclassified cases.
Abstract:
This study describes sagittal plane gait patterns in a representative sample of children with hemiplegic cerebral palsy (CP). Ninety-four children were prospectively recruited to the study (age range 5-18 yrs, mean age 10 yrs 7 mo) and valid kinematic data was captured for 91 participants. Data was also captured for 49 children (age range 5-18 yrs, mean age 10 yrs) with no physical impairment. One representative gait cycle from each child was exported to an Excel template and run through an algorithm that facilitated the description of gait, using logical arguments derived from Winters' Classification. Children with hemiplegic CP, regardless of past surgery history, were allocated to the following gait types: Groups IV (n=9; 10%), III (n=7: 8%), II (n=5: 5%), I (n=32: 35%) and not classified (n=38: 42%). For children with no lower limb surgical history (n=61), gait types were: Groups IV (n=7: 12%), III (n=2: 3%), II (n=2: 3%), I (n=20: 33%) and not classified (n=30: 49%). The gait data taken from children with no physical impairment were not classified. The ability of the Winters' classification system to distinguish between children with higher levels of hemiplegic involvement and children with no physical impairment was demonstrated: the majority of children with hemiplegic CP present with relatively minor gait deviations. A more complete definition of sagittal plane ankle joint kinematics may account for those children that were not classified.
