Diagnostic Gait Analysis Technique for Cerebral Palsy

Abstract

Children with cerebral palsy (CP) develop very complex motor coordination and movement disorders that have a major impact on how the child walks. Although the primary etiology for CP resides with pathology in the central nervous system, during growth and development very significant secondary deformities occur in the musculoskeletal system. This combination of issues relating to the central nervous system around motor control, balance, and body coordination along with multiple musculoskeletal compensations make understanding pathologic gait in CP very difficult. In order to develop complex treatment plans, very detailed analysis and assessments of the child’s gait are required. These plans may include major surgical interventions which have significant risks and complications. The surgical interventions should not be undertaken unless there is a full comprehensive assessment and understanding of the expected outcomes. Measuring human walking with techniques that delineate the functional components is called gait analysis. This analysis is a critical process in understanding the problems of children with abnormal gait. The analysis needs to be performed with the same scientific understanding and organization upon which modern medical practice is based. This evaluation process follows the modern medical evaluation model currently used in almost all medical disciplines, which means physicians always start with a history and physical examination, and then order additional tests as indicated by the initial data. With gait, the additional tests include structured video recording, kinematic and kinetic evaluation, understanding muscle activation patterns with electromyogram (EMG), pediabarograph, and measuring the energy demands of walking. An assessment of the actual amount of day to day ambulation should also be considered.