Skip to main content

Diagnostic Gait Analysis Use in the Treatment Protocol for Cerebral Palsy

  • Living reference work entry
  • First Online:
Handbook of Human Motion
  • 421 Accesses

Abstract

Gait analysis is the detailed examination of precisely measured human motion to better understand the pattern and the mechanisms producing the specific gait pattern. Its history closely parallels the development of computer power which also allowed other medical imaging techniques such as magnetic resonance imaging (MRI) to become useful diagnostic tools. Gait analysis is a very useful tool that is used in carefully planned IRB approved research studies to analyze the pathology of different gait patterns and to develop an understanding of how these respond to planned interventions such as bracing, therapy, or surgery. Gait analysis is also a useful diagnostic tool to be applied to an individual patient with the goal of measuring the patients’ unique and particular gait to generate a more informed prescription for a treatment plan to improve the tested individual’s gait function. Regardless, if the gait analysis is being done for research or diagnostic purposes, the analysis should be done in a well-defined medical facility with medical grade quality control to assure the validity of the testing. The results of this testing should be interpreted by a team of experts of the disease process being studied. The basic diagnostic clinical gait laboratory doing diagnostic testing on the gait of children with ambulatory cerebral palsy should include as a minimum a motion capture system that allows measuring three-dimensional kinematics, that is synchronized with a dynamic electromyography (EMG) system, and force plate to measure the ground reaction force. A pedobarograph system to assess foot posture, a system to perform indirect calorimetry to measure the energy cost of walking, and a community activity monitoring system are other components of the laboratory that can provide diagnostically useful information. For children with ambulatory cerebral palsy, the complexity of the gait assessment usually means this is carried out in a tertiary care center with high volume experience in managing these problems.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Institutional subscriptions

References

  • Aktas S, Aiona M, Orendurff M (1998) Evaluation of rotational gait abnormality in patients with cerebral palsy. Gait Posture 7:182

    Article  Google Scholar 

  • Baumann JU (1984) Clinical experience of gait analysis in the management of cerebral palsy. Prosthetics Orthot Int 8:29–32

    Google Scholar 

  • Chang FM, Seidl AJ, Muthusamy K, Meininger AK, Carollo JJ (2006) Effectiveness of instrumented gait analysis in children with cerebral palsy – comparison of outcomes. J Pediatr Orthop 26:612–616

    Article  Google Scholar 

  • Cook RE, Schneider I, Hazlewood ME, Hillman SJ, Robb JE (2003) Gait analysis alters decision-making in cerebral palsy. J Pediatr Orthop 23:292–295

    Google Scholar 

  • Del Pilar Duque Orozco M, Abousamra O, Church C, Lennon N, Henley J, Rogers KJ, Sees JP, Connor J, Miller F (2016) Reliability and validity of Edinburgh visual gait score as an evaluation tool for children with cerebral palsy. Gait Posture 49:14–18

    Article  Google Scholar 

  • DeLuca PA, Davis RB 3rd, Ounpuu S, Rose S, Sirkin R (1997) Alterations in surgical decision making in patients with cerebral palsy based on three-dimensional gait analysis. J Pediatr Orthop 17:608–614

    Article  Google Scholar 

  • DeLuca PA, Ounpuu S, Davis RB, Walsh JH (1998) Effect of hamstring and psoas lengthening on pelvic tilt in patients with spastic diplegic cerebral palsy. J Pediatr Orthop 18:712–718

    Google Scholar 

  • Desloovere K, Molenaers G, Feys H, Huenaerts C, Callewaert B, Van de Walle P (2006) Do dynamic and static clinical measurements correlate with gait analysis parameters in children with cerebral palsy? Gait Posture 24:302–313

    Article  Google Scholar 

  • Domagalska M, Szopa A, Syczewska M, Pietraszek S, Kidon Z, Onik G (2013) The relationship between clinical measurements and gait analysis data in children with cerebral palsy. Gait Posture 38:1038–1043

    Article  Google Scholar 

  • Ehrig RM, Heller MO, Kratzenstein S, Duda GN, Trepczynski A, Taylor WR (2011) The SCoRE residual: a quality index to assess the accuracy of joint estimations. J Biomech 44(7):1400–1404

    Article  Google Scholar 

  • Ferrari A, Brunner R, Faccioli S et al (2014) Gait analysis contribution to problems identification and surgical planning in CP patients: an agreement study. Eur J Phys Rehabil Med

    Google Scholar 

  • Gage JR, Fabian D, Hicks R, Tashman S (1984) Pre- and postoperative gait analysis in patients with spastic diplegia: a preliminary report. J Pediatr Orthop 4:715–725

    Article  Google Scholar 

  • Gage JR (1991) Gait analysis in cerebral palsy. MacKeith Press, New York

    Google Scholar 

  • Hullin MG, Robb JE, Loudon IR (1996) Gait patterns in children with hemiplegic spastic cerebral palsy. J Pediatr Orthop B 5:247–251

    Article  Google Scholar 

  • Krebs DE, Edelstein JE, Fishman S (1985) Reliability of observational kinematic gait analysis. Phys Ther 65(7):1027–1033

    Article  Google Scholar 

  • Lofterød B, Terjesen T (2008) Results of treatment when orthopaedic surgeons follow gait-analysis recommendations in children with CP. Dev Med Child Neurol 50(7):503–509

    Article  Google Scholar 

  • Lofterod B, Terjesen T, Skaaret I, Huse AB, Jahnsen R (2007) Preoperative gait analysis has a substantial effect on orthopedic decision making in children with cerebral palsy: comparison between clinical evaluation and gait analysis in 60 patients. Acta Orthop 78:74–80

    Article  Google Scholar 

  • McMulkin ML, Gulliford JJ, Williamson RV, Ferguson RL (2000) Correlation of static to dynamic measures of lower extremity range of motion in cerebral palsy and control populations. J Pediatr Orthop 20:366–369

    Google Scholar 

  • Novacheck TF, Trost JP, Sohrweide S (2010) Examination of the child with cerebral palsy. Orthop Clin North Am 41:469–488

    Article  Google Scholar 

  • Orendurff MS, Chung JS, Pierce RA (1998) Limits to passive range of joint motion and the effect on crouch gait in children with cerebral palsy. Gait Posture 7(2):165–165

    Article  Google Scholar 

  • Ong AM, Hillman SJ, Robb JE (2008) Reliability and validity of the Edinburgh visual gait score for cerebral palsy when used by inexperienced observers. Gait Posture 28:323–326

    Article  Google Scholar 

  • Ounpuu S, Bell KJ, Davis RB 3rd, DeLuca PA (1996) An evaluation of the posterior leaf spring orthosis using joint kinematics and kinetics. J Pediatr Orthop 16:378–384

    Article  Google Scholar 

  • Radler C, Kranzl A, Manner HM, Höglinger M, Ganger R, Grill F (2010) Torsional profile versus gait analysis: consistency between the anatomic torsion and the resulting gait pattern in patients with rotational malalignment of the lower extremity. Gait Posture 32(3):405–410

    Article  Google Scholar 

  • Rang M, Wright J (1989) What have 30 years of medical progress done for cerebral palsy? Clin Orthop Relat Res 247:55–60

    Google Scholar 

  • Rathinam C, Bateman A, Peirson J, Skinner J (2014) Observational gait assessment tools in paediatrics – a systematic review. Gait Posture 40(2):279–285

    Article  Google Scholar 

  • Saleh M, Murdoch G (1985) In defense of gait analysis. Observation and measurement in gait assessment. J Bone Joint Surg Brit 67(2):237–241

    Google Scholar 

  • Sankar WN, Rethlefsen SA, Weiss J, Kay RM (2009) The recurrent clubfoot: can gait analysis help us make better preoperative decisions? Clin Orthop Relat Res 467(5):1214–1222

    Article  Google Scholar 

  • Saunders JDM, Inman VT, Eberhart HD (1953) The major determinants in normal and pathological gait. J Bone Joint Surg 35A:543–728

    Article  Google Scholar 

  • Sutherland DH (2001) The evolution of clinical gait analysis part l: kinesiological EMG. Gait Posture 14:61–70

    Article  Google Scholar 

  • Sutherland DH (2002) The evolution of clinical gait analysis. Part II kinematics. Gait Posture 16:159–179

    Article  Google Scholar 

  • Sutherland DH (2005) The evolution of clinical gait analysis part III--kinetics and energy assessment. Gait Posture 21:447–461

    Article  Google Scholar 

  • Sutherland DH, Hagy JL (1972) Measurement of gait movements from motion picture film. J Bone Joint Surg Am 54:787–797

    Article  Google Scholar 

  • Waters RL, Garland DE, Perry J, Habig T, Slabaugh P (1979) Stiff-legged gait in hemiplegia surgical correction. J Bone Joint Surg Am 61:927–933

    Article  Google Scholar 

  • Wren TA, Kalisvaart MM, Ghatan CE, Rethlefsen SA, Hara R, Sheng M, Chan LS, Kay RM (2009) Effects of preoperative gait analysis on costs and amount of surgery. J Pediatr Orthop 29:558–563

    Article  Google Scholar 

  • Wren TA, Otsuka NY, Bowen RE, Scaduto AA, Chan LS, Sheng M, Hara R, Kay RM (2011) Influence of gait analysis on decision-making for lower extremity orthopaedic surgery: baseline data from a randomized controlled trial. Gait Posture 34:364–369

    Article  Google Scholar 

  • Wren TA, Elihu KJ, Mansour S, Rethlefsen SA, Ryan DD, Smith ML, Kay RM (2013a) Differences in implementation of gait analysis recommendations based on affiliation with a gait laboratory. Gait Posture 37:206–209

    Article  Google Scholar 

  • Wren TA, Lening C, Rethlefsen SA, Kay RM (2013b) Impact of gait analysis on correction of excessive hip internal rotation in ambulatory children with cerebral palsy: a randomized controlled trial. Dev Med Child Neurol 55:919–925

    Article  Google Scholar 

  • Wren TA, Otsuka NY, Bowen RE, Scaduto AA, Chan LS, Dennis SW, Rethlefsen SA, Healy BS, Hara R, Sheng M, Kay RM (2013c) Outcomes of lower extremity orthopedic surgery in ambulatory children with cerebral palsy with and without gait analysis: results of a randomized controlled trial. Gait Posture 38:236–241

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Freeman Miller .

Editor information

Editors and Affiliations

Section Editor information

Rights and permissions

Reprints and permissions

Copyright information

© 2017 Springer International Publishing AG

About this entry

Cite this entry

Miller, F., Henley, J. (2017). Diagnostic Gait Analysis Use in the Treatment Protocol for Cerebral Palsy. In: MĂĽller, B., et al. Handbook of Human Motion. Springer, Cham. https://doi.org/10.1007/978-3-319-30808-1_48-1

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-30808-1_48-1

  • Received:

  • Accepted:

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-30808-1

  • Online ISBN: 978-3-319-30808-1

  • eBook Packages: Springer Reference EngineeringReference Module Computer Science and Engineering

Publish with us

Policies and ethics