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Motor function levels and pelvic parameters in walking or ambulating children with cerebral palsy
J-C Bernard1, J Deceuninck2, S Leroy-Coudeville1
1Service de MPR pédiatrique, Croix-Rouge française, centre médico-chirurgical de réadaptation des massues, 92, rue Édmond-Locard, 69322 Lyon cedex 05, France.
Insights
Pelvic tilt in children with cerebral palsy changes with motor function level (GMFCS). Sacrum position shifts backward as functional status decreases from GMFCS level I to IV.
Area of Science:
- Pediatric Orthopedics
- Biomechanical Analysis
- Cerebral Palsy Research
Background:
- Spinal and pelvic alignment strategies in children with cerebral palsy (CP) can differ based on functional ability.
- Understanding these variations is crucial for managing CP-related musculoskeletal issues.
Purpose of the Study:
- To investigate the correlation between motor function (Gross Motor Function Classification System [GMFCS] levels I-IV) and spinal/pelvic parameters in children and adolescents with CP.
- To analyze how pelvic incidence and pelvic tilt relate to GMFCS levels.
Main Methods:
- A cohort of 114 children and adolescents with CP (ages 4-17) was studied.
- Sagittal X-rays of the spine in a standing position were analyzed using specialized Optispine® software.
- Statistical analysis identified significant correlations between GMFCS levels and pelvic parameters.
Main Results:
- Significant correlations were found between GMFCS level and both pelvic incidence and pelvic tilt (P=0.013 and 0.021).
- Pelvic parameters demonstrated variability across different GMFCS levels.
Conclusions:
- Pelvic parameters are associated with GMFCS levels in children with CP.
- While pelvic parameters vary, they do not appear to influence spinal curvature.
- The sacrum's position relative to the femur changes with GMFCS, moving backward from a negative pelvic tilt (GMFCS I) to a positive pelvic tilt (GMFCS II-IV).
Background:
In children with cerebral palsy, spinal equilibrium and pelvic strategies may vary according to the functional status.
Objectives:
To study the relationship between motor function and pelvic and spinal parameters in a population of children and adolescents with cerebral palsy (rated from level I to level IV on Gross Motor Function Classification System [GMFCS]). A sagittal X-ray of the spine in the standing position was analyzed with Optispine(®) software.
Results:
The study population comprised 114 children and adolescents (mean [range] age: 12.35 [4-17]). For the study population as a whole, there were significant overall correlations between the GMFCS level on one hand and pelvic incidence and pelvic tilt (PT) on the other (P=0.013 and 0.021, respectively).
Discussion:
Pelvic parameters vary according to the GMFCS level but do not appear to affect spinal curvature. The sacrum is positioned in front of the head of the femur (i.e. negative PT) in GMFCS level I and progressively moves backwards (i.e. positive PT) in GMFCS levels II, III and IV.
