Presurgical 3D gait analysis findings in four children with spastic cerebral palsy

Abstract

Introduction: Children with spastic palsy present usually with an altered gait pattern. This pattern presents various superimposed alterations, due to spasticity and due to musculosqueletal deformities; some of them are principal and some of them are compensatory mechanisms developed by the patient. Due to the complexity of the clinical analysis of these patients, automatic gait analysis is a very usefull tool Material y methods: We have studied four children: 2 of 5, one of 4 and another of 9 years old. All of them had independent gait with walkers or cane aids. We have performed a kinematic study of articular movement (pelvis, hip, knee, and heel); a kinetic study of power and strength used during movement of these articulations; and a dynamic surface electromyography (sEMG) study. For the adquisition of kinematic and kinetic data we used a VICON system with 6 infrared cameras that register the movement in the space of antropometric markers attached to the patient and two dynamometric platforms which register the ground reaction force. For the adquisition of EMG we used a Biopac system (MP100) with 4 wireless channels, integrating on real time the EMG analogic signal with the VICON system. Results: We observed alterations in the kinematic of articulations that were different for each patient and we cannot define a common pattern of gait. In kinetic studies we observed an increase in the excentric and concentric involvement of several articulations. Gait parameters were also altered in the four patients. Conclusion: Automatic gait study allows us to specify and cuantify what articulations and muscles are envolved in the altered gait. We also can register and cuantify spasticity, determine whether spasticity is generalized or not and if there are associated morphological deformities or alterations.