Related Experiment Video
Updated: Apr 13, 2026
Author Spotlight: Repetitive Transcranial Magnetic Stimulation Combined with Movement Observation in Cerebral Palsy
Published on: August 9, 2024
Variation in kinematic and spatiotemporal gait parameters by Gross Motor Function Classification System level in
Sylvia Õunpuu1, George Gorton2, Anita Bagley3
1Center for Motion Analysis, Division of Orthopaedics, Connecticut Children's Medical Center, Farmington, CT, USA.
Insights
Gait patterns in children with bilateral spastic cerebral palsy (BSCP) vary by Gross Motor Function Classification System (GMFCS) level. However, specific gait kinematics cannot reliably identify GMFCS levels in individuals with BSCP.
Area of Science:
- Biomechanics
- Pediatric Neurology
- Movement Science
Background:
- Bilateral spastic cerebral palsy (BSCP) affects motor function in children and adolescents.
- Gait analysis is crucial for understanding motor impairments in BSCP.
- The Gross Motor Function Classification System (GMFCS) categorizes functional motor abilities.
Purpose of the Study:
- To investigate differences in gait kinematics and spatiotemporal parameters in ambulatory children and adolescents with BSCP across GMFCS levels I-III.
- To compare gait patterns of individuals with BSCP to a typically developing cohort.
Main Methods:
- Retrospective review of 3D gait analysis (3DGA) data from 292 children and adolescents with BSCP.
- Data stratified by GMFCS levels (I-III) and compared to a typically developing group.
- Analysis of kinematic and spatiotemporal gait parameters.
Main Results:
- Gait patterns in all GMFCS levels of BSCP differed from typically developing individuals.
- Increased GMFCS levels correlated with greater deviations in 21 out of 28 gait parameters.
- Significant differences in parameters like initial contact knee angle were observed, but substantial overlap existed among GMFCS levels.
Conclusions:
- GMFCS levels are not reliably identifiable through specific gait kinematics alone.
- Comprehensive 3DGA is essential for guiding treatment decisions in BSCP by measuring individual joint-level gait impairments.
Aim:
The aim of this study was to examine differences in gait kinematics and spatiotemporal parameters in ambulatory children and adolescents with bilateral spastic cerebral palsy (BSCP) among Gross Motor Function Classification System (GMFCS) levels I-III.
Method:
A retrospective review was conducted of individuals with BSCP who had three-dimensional motion analysis (3DGA) at one of seven pediatric hospitals. Means and standard deviations of each gait parameter were stratified by GMFCS levels (I-III) and for a typically developing comparison group.
Results:
Data from 292 children and adolescents with BSCP (189 males, 103 females; mean age 13 y) were compared to a typically developing comparison group (24 male, 26 female; mean age 10 y 6 mo). Gait patterns differed from typically developing in all GMFCS levels, with increasing deviation as GMFCS level increased in 21 out of 28 parameters. Despite significant differences in selected mean kinematic parameters among GMFCS levels such as knee angle at initial contact of 24°, 29°, and 41° in GMFCS levels I, II and III respectively, there was also substantial overlap among GMFCS levels.
Interpretation:
GMFCS levels cannot be identified using specific gait kinematics. Treatment decisions should be guided by comprehensive 3DGA that allows measurement of gait impairments at the joint level for each individual.
