Gait patterns in children with hemiplegic spastic cerebral palsy

Twenty-six nonoperated spastic hemiplegic children underwent three-dimensional kinetic gait analysis. We identified five patterns based on sagittal plane kinetics. Group I had a minimal gait disturbance, a drop foot pattern, and normal kinetics, Group II had a flexed knee but normal hip extension, Group III a flexed knee and hip, Group IV knee hyperextension and tibial arrest, and Group V knee hyperextension and persistent ankle dorsiflexion. We concluded that Group I had weak anterior tibial muscles, and in stance Group II a functionally tight gastrocnemius, Group III a functionally tight gastrocnemius and hip flexors, and Group IV a functionally tight soleus, and in Group V the patients generated an abnormally large fore-aft shear force and the gastrocnemius and soleus were not tight. Kinetics help in the understanding of gait aberrations in spastic hemiplegia.