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Common gait abnormalities of the knee in cerebral palsy
1Department of Orthopaedic Surgery, University of California, San Diego.
Insights
Children with cerebral palsy often have knee gait abnormalities like jump knee or crouch knee. Identifying these specific knee disorders through gait analysis aids in better treatment planning.
Area of Science:
- Orthopedics
- Pediatric Neurology
- Biomechanical Engineering
Background:
- Gait abnormalities in children with cerebral palsy stem from joint contractures, muscle spasticity, and abnormal muscle activation.
- Dysfunctions in one lower extremity joint often impact others, yet primary issues at each joint can be identified.
Purpose of the Study:
- To identify and describe the four primary gait abnormalities of the knee in children with cerebral palsy.
- To detail the motion analysis laboratory profile for each abnormality, including physical examination, motion parameters, electromyography (EMG) data, and force plate data.
- To consider common etiologies and gait consequences for each identified knee disorder.
Main Methods:
- Review of gait analysis data from over 588 pediatric patients with cerebral palsy.
- Detailed description of four common knee gait abnormalities: jump knee, crouch knee, stiff knee, and recurvatum knee.
- Analysis of physical examination findings, kinematic and kinetic data, and electromyography (EMG) from motion analysis.
Main Results:
- Four primary knee gait abnormalities in cerebral palsy were identified: jump knee, crouch knee, stiff knee, and recurvatum knee.
- Each abnormality is characterized by a distinct motion analysis laboratory profile.
- The study outlines the typical causes and effects on gait for each of these knee conditions.
Conclusions:
- Recognizing specific primary knee gait abnormalities in children with cerebral palsy is crucial.
- Detailed gait analysis, including EMG and force plate data, provides a comprehensive understanding of these conditions.
- Accurate identification of pathologic gait patterns facilitates precise patient analysis and treatment strategies.
Abstract:
Gait abnormalities in children with cerebral palsy are the consequence of contractures across joints, muscle spasticity, and phasically inappropriate muscle action. Though abnormalities involving one of the major joints of the lower extremity will usually have consequences on the function of the other joints, it is possible to recognize certain primary disorders at each joint. The most common gait abnormalities of the knee in patients with cerebral palsy occur in the sagittal plane. Based on the experience gained from performing gait analysis on more than 588 patients with cerebral palsy, four primary gait abnormalities of the knee have been identified: jump knee, crouch knee, stiff knee, and recurvatum knee. In this review, each abnormality is described by its motion analysis laboratory profile (physical examination, motion parameters, electromyography [EMG] data, and force plate data). The most common etiologies and the consequences for gait of each disorder are also considered. Appreciation of the most common pathologic patterns of gait should facilitate accurate and detailed analysis of the individual patient with gait abnormalities.
