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Updated: Aug 9, 2025
Clinical-oriented Three-dimensional Gait Analysis Method for Evaluating Gait Disorder
Published on: March 4, 2018
The Variable Influence of Orthotic Management on Hip and Pelvic Rotation in Children with Unilateral Neurogenic
Domenic Grisch1, Manuela Stäuble1, Sandra Baumgartner2
1Department of Pediatric Orthopedics, Neuroorthopedics and Traumatology, University Children's Hospital Zurich, 8032 Zurich, Switzerland.
Insights
Orthotic management for equinus deformity in children with cerebral palsy partially corrected pelvic rotation but did not significantly alter hip rotation, suggesting multifactorial causes for gait asymmetry.
Area of Science:
- Pediatric Orthopedics
- Biomechanical Engineering
- Rehabilitation Medicine
Background:
- Equinus deformity is common in children with spastic cerebral palsy and hemiplegia.
- This condition may hypothetically cause pelvic retraction and hip internal rotation during gait.
- Orthoses aim to correct equinus and promote heel-strike gait.
Purpose of the Study:
- To investigate if orthotic equinus correction reduces rotational hip and pelvic asymmetries.
- To analyze the impact of orthoses on gait parameters in children with specific neurological conditions.
Main Methods:
- Retrospective analysis of 34 children with unilateral spastic cerebral palsy or hemiplegia.
- Standardized instrumented 3D gait analysis with and without orthotic equinus management.
- Analysis of torsional profiles, ankle dorsiflexion, femoral anteversion, and hip/pelvic kinematics and kinetics.
Main Results:
- Orthoses corrected pes equinus and pelvic internal rotation during stance and swing phases.
- No significant changes were observed in hip rotation or rotational moments with orthotic use.
- Orthotic management and femoral anteversion did not correlate with pelvic and hip asymmetry.
Conclusions:
- Orthotic correction of equinus has a variable effect on hip and pelvic asymmetry.
- Hip and pelvic internal rotation appear to be multifactorial, not solely driven by equinus.
- Further research is needed to understand the complex causes of gait asymmetry in this population.
Background:
Equinus deformity with or without concomitant drop foot is a common finding in children with unilateral spastic cerebral palsy and spastic hemiplegia of other causes. Hypothetically, these deformities may lead to pelvic retraction and hip internal rotation during gait. Orthoses are used to reduce pes equinus during gait and to restore hindfoot first contact.
Objective:
We aimed to investigate whether the use of orthotic equinus correction reduces rotational hip and pelvic asymmetries.
Methods:
In a retrospective study, 34 children with unilateral spastic cerebral palsy or spastic hemiplegia of other causes underwent standardized instrumented 3D gait analysis with and without orthotic equinus management. We analyzed the differences in the torsional profile during barefoot walking and while wearing orthoses, as well as investigated the influence of ankle dorsiflexion and femoral anteversion on pelvic and hip kinematics and hip kinetics.
Results:
Wearing orthoses corrected pes equinus and pelvic internal rotation at the end of the stance phase and in the swing phase compared to barefoot walking. Hip rotation and the rotational moment did not significantly change with orthoses. Orthotic management or femoral anteversion did not correlate to pelvic and hip asymmetry.
Conclusion:
The findings indicate that the correction of the equinus by using orthoses had a variable effect on the asymmetry of the hip and pelvis and internal rotation; both appear to have a multifactorial cause that is not primarily driven by the equinus component.
