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How multi segmental patterns deviate in spastic diplegia from typical developed.

Matteo Zago1, Chiarella Sforza2, Alessia Bona3

  • 1Department of Electronics, Information and Bioengineering (DEIB), Politecnico di Milano, Piazza Leonardo da Vinci 32, 20133 Milano, Italy; Department of Biomedical Sciences for Health, Università degli Studi di Milano, via Mangiagalli 31, 20133 Milano, Italy.

Clinical Biomechanics (Bristol, Avon)
|August 15, 2017
PubMed
Summary

Principal Component Analysis revealed distinct gait patterns in children with Cerebral Palsy (CP), highlighting compensatory strategies. This method offers a quantitative approach to understanding multi-joint movement connections in CP gait.

Keywords:
Cerebral palsyGait analysisPrincipal MovementsPrincipal component analysis

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Area of Science:

  • Biomechanical analysis
  • Pediatric orthopedics
  • Movement science

Background:

  • The relationship between gait characteristics and coordination in children with Cerebral Palsy (CP) requires further investigation.
  • Principal Component Analysis (PCA) is a valuable tool for deconstructing complex movements into fundamental components, termed Principal Movements.
  • Understanding these components is crucial for characterizing multi-joint gait patterns in CP.

Purpose of the Study:

  • To quantitatively characterize the functional connections between multi-joint gait patterns in children with spastic diplegia.
  • To apply Principal Component Analysis to identify and analyze the principal movements during gait in children with CP.
  • To compare gait patterns between children with CP and typically developing peers.

Main Methods:

  • Standardized gait analysis was performed on 65 children with spastic diplegia (mean age 10.6 years) and 31 typically developing adolescents (mean age 13.6 years).
  • Participants were categorized into Crouch or knee Hyperextension groups based on standing knee flexion angle to assess postural effects on gait.
  • Three-dimensional coordinates of key joints (hips, knees, ankles, metatarsals, pelvis, shoulders) were analyzed using Principal Component Analysis.

Main Results:

  • Four Principal Movements explained 99% of the global variance in gait, with components 1-3 representing sagittal plane movements and components 4-6 addressing frontal plane movements and refinements.
  • Gait dimensionality was significantly higher in children with CP compared to controls (p<0.01).
  • The Crouch group showed significant differences from controls in components 1 and 4-6 (p<0.05), while the knee Hyperextension group differed in components 1-2 and 5 (p<0.05).

Conclusions:

  • Compensatory strategies in children with CP were objectively identified through the interactions between main and secondary movement patterns.
  • Principal Movements provide an efficient and quantitative method for interpreting gait reports, offering immediate insights into movement component connections.
  • This approach aids in a clearer understanding of gait deviations and compensatory mechanisms in Cerebral Palsy.