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Updated: Jun 26, 2025
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Published on: March 4, 2018
Gait Compensation among Children with Non-Operative Legg-Calvé-Perthes Disease: A Systematic Review
Abdulrhman Mashabi1, Rula Abdallat2, Mohammed S Alghamdi3
1Department of Physical Therapy, College of Medical Rehabilitation Sciences, Taibah University, Al-Madinah Al-Munawarah 42353, Saudi Arabia.
Insights
Children with Perthes disease often exhibit Trendelenburg gait due to hip abductor weakness. This systematic review identifies common gait compensation patterns in these young patients for better management.
Area of Science:
- Pediatric Orthopedics
- Biomechanics
- Gait Analysis
Background:
- Perthes disease impacts children's walking patterns due to hip joint blood circulation issues.
- Understanding gait strategies is crucial for objective assessment and management of Perthes disease.
Purpose of the Study:
- To systematically review and identify gait compensation patterns in children with non-operative Perthes disease.
Main Methods:
- Systematic literature search across major databases (MEDLINE, CINAHL, Embase, etc.) up to December 2023.
- Methodological quality and risk of bias assessed using an adapted Downs and Black checklist.
- Statistical analysis included percentage agreement and kappa statistics.
Main Results:
- 277 citations were reviewed, with 210 undergoing full-text screening.
- Eight studies met inclusion criteria for quality assessment.
- Data quality varied, with scores indicating missing information on subject characteristics, biomechanical models, and power calculations.
Conclusions:
- Common compensation strategies in non-operative Perthes disease include Trendelenburg gait.
- Hip abductor muscle weakness is a key factor contributing to observed gait deviations.
Abstract:
Perthes disease is a condition that affects walking patterns in young children due to poor blood circulation in the hip joint. Understanding the gait strategies of affected children is of great importance for an objective assessment and better management of this condition. The aim of this systematic review was to evaluate the current literature to identify gait compensation patterns in non-operative children with Perthes disease.
Methods:
A systematic electronic search was performed using MEDLINE, CINAHL, Embase, BIOSIS, and the Cochrane Library to identify studies published from inception up until December 2023. An adapted Downs and Black checklist was utilised to assess methodological quality and project risk of bias. Percentage agreement and nominal kappa statistics with bootstrapped bias-corrected 95% confidence intervals (CIs) were used.
Result:
A comprehensive literature search revealed 277 citations for review, of which 210 studies entered full-text screening. In total, eight studies met the inclusion criteria for quality assessment by two independent reviewers. The results revealed variations in data quality, with scores ranging from 12 to 17 due to missing information related to subject characteristics, biomechanical model, and power calculation.
Conclusions:
This review reveals common compensation strategies associated with walking among non-operative children with Perthes disease such as Trendelenburg gait due to weakness of the hip abductor muscle.
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