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Three-Dimensional Instrumented Gait Analysis for Children With Cerebral Palsy: An Evidence-Based Clinical Practice

Rebecca A States1, Yasser Salem, Joseph J Krzak

  • 1Physical Therapy Program, School of Health Professions and Human Services, Hofstra University, Hempstead, New York (Drs States and Salem); Faculty of Physiotherapy, Cairo University, Cairo, Egypt (Dr Salem); Midwestern University - Physical Therapy Program, Downers Grove, Illinois (Dr Krzak); Shriners Children's Chicago, Gerald F. Harris Motion Analysis Center, Chicago, Illinois (Dr Krzak); Department of Physical Therapy, Long Island University - Brooklyn, Brooklyn, New York (Dr Godwin); Shriners Children's Spokane, Walter E. & Agnes M. Griffin Motion Analysis Center, Spokane, Washington (Dr McMulkin); Department of Rehabilitation & Movement Sciences, Rutgers, The State University of New Jersey, Newark, New Jersey (Dr Kaplan).

Pediatric Physical Therapy : the Official Publication of the Section on Pediatrics of the American Physical Therapy Association
|April 3, 2024
PubMed
Summary

This guideline helps physical therapists and doctors use 3-dimensional instrumented gait analysis (3D-IGA) to assess and treat walking issues in children with cerebral palsy (CP). It provides actionable steps for better clinical decisions and interventions.

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Area of Science:

  • Biomedical Engineering
  • Clinical Biomechanics
  • Pediatric Physical Therapy

Background:

  • Children with cerebral palsy (CP) exhibit complex gait deviations requiring interventions.
  • 3-dimensional instrumented gait analysis (3D-IGA) offers detailed insights into walking mechanics, including kinematics, kinetics, and muscle activity.

Purpose of the Study:

  • To provide physical therapists (PTs), physicians, and clinicians with 7 action statements on utilizing 3D-IGA for children with CP.
  • To guide the application of 3D-IGA in clinical assessments and intervention planning.
  • To link action statement grades with evidence levels from literature appraisal.

Main Methods:

  • Development of a clinical practice guideline based on critical appraisal of existing literature.
  • Formulation of evidence-based action statements for 3D-IGA application in pediatric CP.
  • Inclusion of best practice statements for 3D-IGA laboratory standards.

Main Results:

  • The guideline offers 7 action statements for integrating 3D-IGA into clinical practice for children with CP.
  • It details how 3D-IGA can inform surgical and non-surgical interventions.
  • Recommendations are provided for laboratory instrumentation, staffing, and reporting.

Conclusions:

  • 3D-IGA is a valuable tool for identifying gait deviations and evaluating intervention effectiveness in children with CP.
  • The guideline supports informed decision-making for PTs and clinicians caring for children with CP.
  • Standardized laboratory practices are recommended for optimal 3D-IGA utility.