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Updated: Nov 25, 2025
Clinical-oriented Three-dimensional Gait Analysis Method for Evaluating Gait Disorder
Published on: March 4, 2018
Kinematic cluster analysis of the crouch gait pattern in children with spastic diplegic cerebral palsy using sparse
Leila Abbasi1, Zahra Rojhani-Shirazi1, Mohsen Razeghi1
1Department of Physiotherapy, School of Rehabilitation Sciences, Shiraz University of Medical Sciences, Shiraz, Iran; Rehabilitation Sciences Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
Insights
This study identified four distinct crouch gait patterns in children with spastic diplegic cerebral palsy. Knee and hip flexion were key factors, with trunk and pelvis movements correlating with gait severity.
Area of Science:
- Biomechanical analysis of gait patterns.
- Pediatric orthopedics and rehabilitation.
Background:
- Crouch gait, characterized by excessive knee flexion, is common in children with spastic diplegic cerebral palsy.
- Previous gait analyses often focused on sagittal plane kinematics of lower extremities, neglecting trunk and pelvis.
- Clustering methods like Sparse K-means can simultaneously perform clustering and variable selection.
Purpose of the Study:
- To define distinct clusters of crouch gait patterns in children with spastic diplegic cerebral palsy.
- To identify key kinematic variables differentiating these clusters.
- To investigate the relationship between trunk, pelvis, and lower extremity kinematics in crouch gait.
Main Methods:
- Cluster analysis using Sparse K-means on 89 kinematic variables.
- Data from 64 limbs of children with crouch gait and 64 limbs of typically developing children.
- Inclusion of lower extremity, pelvis, and trunk kinematic data.
Main Results:
- Four distinct clusters of crouch gait were identified.
- Knee and hip flexion were identified as primary clustering factors.
- Trunk and pelvis kinematics showed strong correlations with the severity of knee and hip flexion.
Conclusions:
- The identified clusters provide a refined classification of crouch gait in this population.
- Increasing knee flexion severity is associated with greater deviations in trunk and pelvis kinematics from typical patterns.
- The defined clusters offer a basis for assessing crouch gait severity and guiding treatment.
Background:
Crouch gait pattern is a common gait pattern in children with diplegic cerebral palsy with excessive knee flexion throughout stance phase. Few studies have grouped this pattern of gait and usually have examined only the features of gait in the sagittal plane and mostly lower extremities without considering pelvis and trunk behavior. Studies usually categorize the gait pattern according to important variables from the researcher's point of view. Sparse K-means is high dimensional clustering methods that perform clustering and variable selection simultaneously even with low sample size and large number of variables. Our aim was to define existing clusters of crouch gait pattern in children with spastic diplegic cerebral palsy.
Methods:
Cluster analysis was applied on the lower extremity, pelvis and trunk gait kinematics data of 64 limbs of children with crouch gait pattern and 64 limbs of typically developing children. Eighty-nine kinematic variables were used as input variables for clustering.
Findings:
Four clusters of crouch gait pattern were defined. Sparse K-means identified influential variables and identified the knee and hip flexion as a major factor in clustering. Kinematic of the trunk, pelvis and ankle was determined in each cluster. Trunk and pelvis kinematic features were strongly correlated with the knee and hip joint flexion severity.
Interpretation:
Obtained clusters were confirmed observationally. With increasing knee flexion, the kinematic of the trunk and pelvis were further away from the patterns of typically developing individuals. The clusters ranking appear to be reasonable based on the crouch severity.
