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Updated: Aug 31, 2025
Clinical-oriented Three-dimensional Gait Analysis Method for Evaluating Gait Disorder
Published on: March 4, 2018
Lower-limb joint-coordination and coordination variability during gait in children with cerebral palsy
C Dussault-Picard1, P Ippersiel2, H Böhm3
1School of Kinesiology and Physical Activity Sciences, Faculty of Medicine, University of Montreal, Canada; Research Center of the Sainte-Justine University Hospital (CRCHUSJ), Canada.
Insights
Children with cerebral palsy exhibit altered gait coordination, showing more in-phase joint patterns and reduced variability. This study highlights the value of continuous relative phase analysis in assessing motor control impairments in pediatric cerebral palsy.
Area of Science:
- Biomedical Engineering
- Clinical Biomechanics
- Pediatric Neurology
Background:
- Cerebral palsy (CP) significantly impacts motor control, affecting fundamental activities like walking.
- Continuous relative phase (CRP) analysis is a valuable tool for quantifying inter-joint coordination and its variability.
- CRP analysis has not been previously applied to study gait in children with CP.
Purpose of the Study:
- To investigate inter-joint coordination and variability during gait in children with CP using CRP analysis.
- To compare gait coordination patterns between children with CP and typically developing children.
- To explore the relationship between gait deviations and coordination metrics in children with CP.
Main Methods:
- 45 children with CP and 45 typically developing children participated.
- Retroreflective markers were used to capture gait kinematics.
- CRP analysis quantified knee-hip and ankle-knee joint coordination and variability.
- The Gait Profile Score (GPS) assessed overall gait pathology.
Main Results:
- Children with CP demonstrated more in-phase knee-hip coupling during key gait events compared to controls.
- Reduced knee-hip and ankle-knee coordination variability was observed in the CP group.
- A negative correlation was found between the GPS and knee-hip inter-joint coordination in children with CP.
Conclusions:
- Children with CP display a less adaptable gait strategy, characterized by in-phase joint patterns and reduced variability, particularly during transitional gait phases.
- The findings underscore the utility of CRP analysis as a sensitive measure for assessing motor control deficits in pediatric CP.
- Coordination analysis provides valuable insights into the relationship between joint movement patterns and overall gait impairment in children with CP.
Background:
Children with cerebral palsy present with poor motor control, altering their ability to perform tasks such as walking. Continuous relative phase analysis is a popular method to quantify motor control impairments via inter-joint coordination and coordination variability; however, it has not been explored in children with cerebral palsy.
Methods:
45 children with cerebral palsy and 45 typically developing children walked while fit with retroreflective markers. Continuous relative phase analysis for knee-hip and ankle-knee joint pairs quantified inter-joint coordination and coordination variability. The Gait Profile Score estimated gait pathology. Group differences were assessed with unpaired t-tests for coordination amplitude and variability (knee-hip, ankle-knee) across gait events. For the cerebral palsy group, correlations assessed the relation between the gait profile score and coordination metrics.
Findings:
The cerebral palsy group showed more in-phase patterns for knee-hip coupling compared to the typically developing group (initial contact, loading response, mid-stance, terminal swing) (p ≤ 0.03). The cerebral palsy group showed lower knee-hip coordination variability (mid-stance, mid-swing) (p ≤ 0.037) and lower ankle-knee coordination variability (initial contact, loading response, terminal swing) (p < 0.001). The gait profile score correlated weakly to moderately (r = [0.323-0.472]), and negatively with the knee-hip inter-joint coordination (initial contact, loading response, mid-stance, terminal swing) (p ≤ 0.042).
Interpretation:
Children with cerebral palsy showed a more in-phase gait strategy during challenging transitional gait cycle phases (beginning and end) and less flexible and adaptable motor behaviors. Moreover, the correlation between in-phase joint patterns and increased gait deviations (gait profile score) reinforces the relevance of coordination analysis to assess motor control impairment.
