Analysis of the causes of pathological patterns of the kinematic locomotor profile based on the findings of computer gait analysis in children with spastic CP types

Chibirov G.M., Dolganova T.I., Dolganov D.V., Popkov D.A.

Abstract


To interpret the clinical gait analysis (CGA), it is necessary to associate changes in gait with clinical impairment and differentiate the primary deviations in the gait stereotype from compensatory adaptive changes.
Purpose
To assess the pathological elements of the locomotor profile according to video gait analysis and clinical examination of patients; to compare the abnormalities identified in gait kinematics with the probable clinical causes of these abnormalities.
Materials and methods
Clinical examination and assessment of the locomotor profile with video gait analysis (CGA) were performed in 46 children (92 limbs) with bilateral spastic types of cerebral palsy (25 boys, 21 girls). We used 6 Qualisys Oqus cameras and one AMTI dynamometric platform (Advanced Mechanical Technology Inc., Watertown, MA, USA) with passive marker video capture technology. The IOR model was used for installing markers. The patterns of the locomotor profile adopted by the Delphic Convention were analyzed. The assessment of diagnostic coincidences or discrepancies was evaluated as percentage rates.
Results
The portion of the pathological elements of the locomotor profile identified according to the video gait analysis and clinical examination of patients is presented in the tables. The positive ratio of the pathological elements of the locomotor profile identified according to the video gait analysis and clinical examination of patients averaged 66.7 %. The lowest error rate: when assessing the limitation of the range of motion of the ankle joint and hip joint there were 82.6% and 81.8% of positive results, respectively.
Discussion
Clinical gait analysis (CGA) is crucial in controversial situations regarding detorsion osteotomies in multilevel operations.
Conclusions
Muscle retraction is the main (primary) clinical sign leading to positional kinematic deviations in joints and segments. The limitation of the range of motion in the knee and ankle joints due to muscle retraction results in secondary contractures of these joints.

Keywords


cerebral palsy, clinical gait analysis

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DOI: http://dx.doi.org/10.18019/1028-4427-2019-25-4-493-500

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