Relationship Between Transverse-plane Kinematic Deviations of Lower Limbs and Gait Performance in Children with Unilateral Cerebral Palsy: A Descriptive Analysis

Abstract

BackgroundTransverse-plane kinematic deviations of lower limbs are common in children with unilateral cerebral palsy (UCP), often with detrimental consequences for gait. Research questionTo identify the most important factor among rotational anomalies of lower limbs for gait in children with UCP. MethodsIn a descriptive observational study, 42 children with UCP (age; 5–8 years) who had the ability of independent walking were included. Comprehensive gait analysis was performed and included assessment of the transverse-plane kinematic deviations of the lower limbs [pelvis, hip, and ankle rotation angles, and foot progression (FP) angle], and spatial-temporal gait features [velocity, step length (SL), single-limb support time (SLSt), temporal gait-symmetry index (T-GSI), and spatial gait-symmetry index (S-GSI)]. Results and SignificanceThe regression analysis indicated that hip rotation was the key determinant of gait velocity (R2 = 0.75, P < .001) and S-GSI (R2 = 0.24, P = .001). The FP angle was the most important factor for T-GSI (R2 = 0.22, P = .002). The ankle rotation explained in part the variance in T-GSI (R2 = 0.10, P = .001). ConclusionGait velocity and spatial gait-symmetry are primarily affected by hip rotation anomalies. The temporal gait-symmetry is generally associated with the FP angle deviation and partly with ankle rotation deviation.