Crouch Gait in Cerebral Palsy: Current Concepts Review

Area of Science:

• Orthopedics
• Neurology
• Biomedical Engineering

Background:

• Crouch gait is the most prevalent pathological gait in cerebral palsy, particularly spastic diplegia.
• It is defined by excessive knee flexion during the stance phase of the gait cycle.

Purpose of the Study:

• To comprehensively review current literature on crouch gait in cerebral palsy.
• To understand its etiology, pathophysiology, biomechanics, natural history, evaluation, and treatment.

Main Methods:

• A literature review was conducted.
• Key areas explored include etiology, pathophysiology, biomechanics, natural history, clinical/radiological evaluation, and treatment options.

Main Results:

• The etiology is multifactorial with poorly understood pathophysiology, complicating management.
• Non-operative methods and spasticity reduction are effective for younger children.
• Surgical interventions, including single event multilevel surgery and growth modulation (anterior distal femur hemiepiphysiodesis), are often necessary due to the progressive nature of crouch gait.

Conclusions:

• Knowledge gaps persist regarding the etiopathogenesis and biomechanics of crouch gait.
• Further research using instrumented gait analysis is recommended.
• Comparative trials focusing on long-term outcomes of various treatments are needed.