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Variation in kinematic and spatiotemporal gait parameters by G ross M otor F unction C lassification S ystem level in children and adolescents with cerebral palsy
Author(s) -
Õunpuu Sylvia,
Gorton George,
Bagley Anita,
SisonWilliamson Mitell,
Hassani Sahar,
Johnson Barbara,
Oeffinger Donna
Publication year - 2015
Publication title -
developmental medicine and child neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.658
H-Index - 143
eISSN - 1469-8749
pISSN - 0012-1622
DOI - 10.1111/dmcn.12766
Subject(s) - gait , gross motor function classification system , cerebral palsy , kinematics , ambulatory , gait analysis , typically developing , physical medicine and rehabilitation , physical therapy , spastic , medicine , psychology , developmental psychology , surgery , autism , physics , classical mechanics
Aim The aim of this study was to examine differences in gait kinematics and spatiotemporal parameters in ambulatory children and adolescents with bilateral spastic cerebral palsy ( BSCP ) among G ross M otor F unction C lassification S ystem ( GMFCS ) levels I‐III. Method A retrospective review was conducted of individuals with BSCP who had three‐dimensional motion analysis (3 DGA ) at one of seven pediatric hospitals. Means and standard deviations of each gait parameter were stratified by GMFCS levels (I‐III) and for a typically developing comparison group. Results Data from 292 children and adolescents with BSCP (189 males, 103 females; mean age 13y) were compared to a typically developing comparison group (24 male, 26 female; mean age 10y 6mo). Gait patterns differed from typically developing in all GMFCS levels, with increasing deviation as GMFCS level increased in 21 out of 28 parameters. Despite significant differences in selected mean kinematic parameters among GMFCS levels such as knee angle at initial contact of 24°, 29°, and 41° in GMFCS levels I , II and III respectively, there was also substantial overlap among GMFCS levels. Interpretation GMFCS levels cannot be identified using specific gait kinematics. Treatment decisions should be guided by comprehensive 3DGA that allows measurement of gait impairments at the joint level for each individual.