Analysis of kinematic and kinetic parameters of pace in cerebral palsy patients with internal torsion hip deformity

Abstract

Literature data on the correlation between femoral torsion during clinical examination and during walking are different. Aim of the study was to compare kinetics and kinematics in cerebral palsy patients with iatrogenic crouch gait pattern with and without clinically diagnosed internal femoral torsion. Material and methods . Comparative analysis of clinical examination and three-dimensional gait analysis (3DGA) was performed in 61 subjects (122 limbs), GMFCS II with iatrogenic crouch gait pattern. The average age was 14.5 ± 2.5 years. This sample was formed in 2018 – 2021. Kinetic and kinematic data were recorded by Qualisys 7+ optical cameras (8 cameras) with passive marker video capture technology, synchronized with six KISTLER dyno platforms (Switzerland). The analysis was performed in the QTM (Qualisys) and Visual3D (C-Motion) programs with automated calculation of values. Based on the clinical data, all the patients were divided as follows: I – no clinically detected internal femoral torsion – 50 limbs, II – clinically detected internal femoral torsion – 68 limbs. Results . Comparison of the values of kinematics and kinetics in groups of patients according to the criterion of clinically detected/not detected had statistically significant differences in kinematics – the maximum and minimum values of femur and tibia torsion relative to the norm. Differential diagnosis of compensated/decompensated internal femoral torsion was represented by multidirectional values of the angle of foot positioning relative to the motion vector. The kinetic parameters in the groups were statistically doubtful, because they depended on the walking speed of patients, their ability to move. Conclusions . The values of maximum femoral torsion angle up to 22° were not clinically interpreted as internal femoral torsion, those from 22° to 28° can be interpreted both with clinically revealed femoral torsion (68 %) and with the absence of femoral torsion (22 %), which corresponds to the risk group, those more than 28° fell into the group of clinically diagnosed internal femoral torsion.