Related Experiment Video
Updated: Feb 19, 2026
Clinical-oriented Three-dimensional Gait Analysis Method for Evaluating Gait Disorder
Published on: March 4, 2018
Pathological Movements of the Pelvis and Trunk During Gait in Children With Cerebral Palsy: A Cross-Sectional Study
Damien Kiernan1, Rory O'Sullivan2, Ailish Malone2
1Gait Laboratory, Central Remedial Clinic, Vernon Ave, Clontarf, Dublin 3, Ireland, and Trinity Centre for Bioengineering, Trinity College Dublin, Dublin, Ireland.
Insights
Children with cerebral palsy (CP) exhibiting Duchenne or complex Trendelenburg-Duchenne gait patterns experience significantly increased lower lumbar spinal loading. This abnormal loading may lead to long-term spinal health implications for these children.
Area of Science:
- Biomechanical analysis of pediatric gait.
- Spinal loading in children with neurological disorders.
Background:
- Children with cerebral palsy (CP) often exhibit increased lumbar spine loading, particularly in the coronal plane.
- Pelvic and trunk movements in Trendelenburg and Duchenne gait patterns are significant in the coronal plane, potentially impacting lower lumbar spinal loading in children with CP.
Purpose of the Study:
- To assess trunk and pelvic kinematics and lower lumbar spinal loading in children with CP and Trendelenburg or Duchenne type gait.
- To identify distinct movement patterns and their association with spinal loading in pediatric CP gait.
Main Methods:
- A cross-sectional study design was employed.
- Three-dimensional kinematic data of the lower limb and thorax, along with L5-S1 kinetic data, were recorded.
- Children were categorized based on clinical presentation of Trendelenburg or Duchenne type gait.
Main Results:
- Three pelvic and trunk movement patterns were identified: Trendelenburg, Duchenne, and complex Trendelenburg-Duchenne.
- Peak L5-S1 lateral bending moments increased by 62% in children with CP and Duchenne gait.
- Children with complex Trendelenburg-Duchenne gait showed the greatest deviations, with significantly increased ipsilateral (69%) and contralateral (54%) moments compared to typically developing children.
Conclusions:
- Trendelenburg and Duchenne movements were not always distinct, with a complex combined pattern being most common.
- Clinicians must recognize that Duchenne or complex Trendelenburg-Duchenne gait patterns in children with CP lead to abnormal spinal loading.
- This abnormal loading has significant potential long-term implications for the health of the lower spine in affected children.
Background:
Increased loading at the lumbar spine, particularly in the coronal plane, has been reported in children with cerebral palsy (CP). As pelvic and trunk movements associated with Trendelenburg and Duchenne type gait are most significant in the coronal plane, the potential exists for lower lumbar spinal loading to be negatively affected in children with CP and these types of movement patterns.
Objective:
The objective of this study was to assess trunk and pelvic kinematics and lower lumbar spinal loading patterns in children with CP and Trendelenburg and Duchenne type gait.
Design:
This was a cross-sectional study.
Methods:
Three-dimensional kinematic (lower limb and thorax) and L5-S1 kinetic data were recorded. Children were divided according to clinical presentation of Trendelenburg or Duchenne type gait. Several discrete kinematic and kinetic parameters were assessed between groups.
Results:
Three distinct pelvic and trunk movement patterns were identified for children with CP: Trendelenburg, Duchenne, and complex Trendelenburg-Duchenne. Peak L5-S1 lateral bending moments were increased by 62% in children with CP and Duchenne type gait. Children with CP and complex Trendelenburg-Duchenne gait demonstrated the largest deviations from normal, with increased peak ipsilateral and contralateral directed moments of 69% and 54%, respectively, compared with children with typical development.
Limitations:
A test-retest reliability analysis or measure of minimal detectable change was not conducted as part of this study. Results suggest that measures of minimal detectable change may be high for some of the reported variables. In addition, the inverse dynamic approach determines only the net intersegmental reactive forces that reflect the effect of external loads. Previous studies have shown that spinal loads may be larger than the net intersegmental force.
Conclusions:
Trendelenburg and Duchenne type movements were not always distinct, and a third type of movement, a combination of the two, was the most common in this study. Clinicians should be aware that children with CP and the Duchenne type or the complex Trendelenburg-Duchenne type of gait pattern experience abnormal loading that may have significant implications for the lower spine in the long term.
