Related Experiment Video
Updated: May 4, 2026
Author Spotlight: Repetitive Transcranial Magnetic Stimulation Combined with Movement Observation in Cerebral Palsy
Published on: August 9, 2024
Flexed-knee gait in children with cerebral palsy: a 10-year follow-up study
Thierry Haumont1, Chris Church2, Shaun Hager2
1Gait Analysis Laboratory, Nemours/Alfred I. duPont Hospital for Children, 1600 Rockland Road, Wilmington, DE 19803 USA ; Department of Orthopaedics, Children's Hospital of Brabois, Nancy, France ; Department of Orthopaedics, Henri Poincaré University, Nancy, France.
Background:
While several studies have evaluated the short-term effectiveness of conservative and surgical treatment of flexed-knee gait in children with cerebral palsy (CP), few have explored the long-term outcomes using gait analysis. The purpose of this study was to examine, through gait analysis, the 10-year outcomes of flexed-knee gait in children with CP.
Methods:
Ninety-seven children with spastic CP who walked with a flexed-knee gait underwent two gait evaluations [age 6.1 ± 2.1 and 16.2 ± 2.3 years, Gross Motor Function Classification System (GMFCS) I (12), II (45), III (37), IV (3)]. Limbs with knee flexion at initial contact >15° were considered walking with a flexed-knee gait and were included in the study (n = 185). Kinematic data were collected using an eight-camera motion analysis system (Motion Analysis, Santa Rosa, CA). Surgical and therapeutic interventions were not controlled.
Results:
A comparison between the two gait studies showed an overall improvement in gait at 10 years follow-up. Significant improvements were seen in knee flexion at initial contact, Gait Deviation Index (GDI), Gross Motor Function Measure (GMFM), and gait speed (P < 0.01 for all). Outcome was also evaluated based on the severity of flexed-knee gait at the initial visit, with functional skills and overall gait (GDI) improving in all groups (P < 0.01 for all). The group with a severe flexed-knee gait exhibited the most improvement, while subjects with a mild flexed-knee improved the least.
Conclusions:
Children at a specialty hospital whose orthopedic care included gait analysis and multi-level surgery showed improvement of flexed-knee gait and gross motor function over a 10-year course, regardless of the initial severity.
