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Updated: Jul 5, 2026
Clinical-oriented Three-dimensional Gait Analysis Method for Evaluating Gait Disorder
Published on: March 4, 2018
Gait analysis in children with bladder exstrophy shows increased hip adduction, knee valgus and external foot
Eva Broström1, Inti Vanmechelen1, Yvonne Haglund-Åkerlund2
1Department of Women´s and Children´s Health, Karolinska Institutet, Stockholm, Sweden; Highly Specialized Pediatric Medicine and Surgical Divisions, Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden.
Insights
Children with bladder exstrophy exhibit altered gait, including wider foot progression and hip adduction, likely due to pelvic anatomy. Osteotomy surgery has minimal impact on their gait patterns.
Area of Science:
- Pediatric Orthopedics
- Biomechanical Analysis
- Developmental Pediatrics
Background:
- Bladder exstrophy is a congenital condition affecting pelvic development and gait.
- Gait patterns in children with bladder exstrophy, particularly post-osteotomy, are not well understood.
Purpose of the Study:
- To investigate and compare gait patterns in children with and without bladder exstrophy.
- To evaluate the influence of osteotomy surgery on gait in children with bladder exstrophy.
Main Methods:
- Three-dimensional gait analysis was performed on 15 children with bladder exstrophy and 19 controls.
- Statistical parametric mapping and t-tests compared kinematic, kinetic, and power data across joints.
Main Results:
- Children with bladder exstrophy showed increased outward foot progression, hip adduction, and knee valgus, with reduced ankle push-off power.
- Osteotomy surgery correlated with higher knee valgus during stance compared to non-osteotomy cases.
Conclusions:
- Wider pelvis in bladder exstrophy likely causes increased hip adduction and foot progression.
- Altered hip and foot mechanics contribute to reduced ankle power push-off.
- Osteotomy surgery appears to have a less significant effect on gait than anticipated.
Background:
Bladder exstrophy is a congenital malformation occurring in fetal development characterized by an open pelvic ring and inferiorly rotated pelvis, impacting typical gait and development. Little is known about the gait patterns in children with bladder exstrophy, especially if they undergo an osteotomy surgery for pelvic reconstruction.
Objective:
This study aimed to investigate gait patterns of children with and without bladder exstrophy, as well as children with bladder exstrophy with and without osteotomies.
Methods:
Fifteen participants with bladder exstrophy (mean age 10.6 y; range 5-15 y) and 19 controls (mean age 11.7 y; range 7-15 y) performed a three-dimensional gait analysis. Statistical parametric mapping compared kinematics, kinetic and power data between groups at the level of the pelvis, hip, knee and ankle. Hotteling's T2 test was used to assess differences at the joint level, followed by post-hoc two-tailed t-tests for individual joint angles.
Results:
The bladder exstrophy group showed more outwards foot progression, more hip adduction during stance and knee valgus during swing compared to controls. The bladder exstrophy group showed lower ankle push-off power compared to controls. Children with osteotomy surgery showed higher knee valgus throughout stance compared to the non-osteotomy group.
Conclusion:
The larger hip adduction and external foot progression in children with bladder exstrophy are most probably inter-related and a consequence of the anatomically wider pelvis. The lower ankle power push-off likely stems from the non-optimal gait pattern caused by deviations at the hip and foot. Osteotomy surgery has less impact on the gait pattern than initially anticipated.
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