Hip Joint Angular Values in Children with Bilateral Spastic Cerebral Palsy: A Comparison between Ambulatory and Nonambulatory Groups According to the Gross Motor Functional Classification System

Abstract

Objective: The aim of this study was to compare the migration index (MI), femoral inclination angle (FIA), lateral center-edge angle (LCEA), and acetabular index (AI) values measured from hip joint radiographs of children with bilateral spastic cerebral palsy (CP) divided into ambulatory and nonambulatory groups according to the Gross Motor Functional Classification System with functional levels of children, and to examine their relationship with anthropometric measurements of the lower extremities. Materials and Methods: The present investigation encompassed the evaluation of 30 children afflicted with CP, through the conduction of hip joint radiographic assessments, which involved the right and left hip joints, the acquisition of images using MI, FIA, LCEA, and AI parameters, as well as measurement of lower-extremity anthropometric data. Results: A significant difference was found between ambulatory and nonambulatory groups in the left MI, FIA, and LCEA (P < 0.05). In comparison of anthropometric measurements to height ratios, no significant difference was found, except for left ankle circumference and bi-iliac diameter measurements (P > 0.05). Conclusion: The hip joint angular values of the ambulatory group were found to be within normal limits compared to those of the nonambulatory group. Although there were significant differences between hip joint angles in the two groups, there was no significant correlation with lower-extremity anthropometric measurements. It was concluded that hip joint angles were more pathological and prone to hip displacement in the nonambulatory group. This study revealed the importance of strategies to maintain and improve the functional capacity of children with CP.