Use of Gait Analysis in the Treatment Decision-Making Process of Patients with Spastic Cerebral Palsy
The aim of this study was to evaluate the gait deviations of patients with spastic cerebral palsy (CP) with computerized gait analysis and to allow objective criteria to physicians for clinical decision making. Medical charts and gait analysis reports of the 43 patients with spastic CP were reviewed, retrospectively. The mean±SD age was 9.5±5.2 years. Seventy-six percent had diplegia and 24% had hemiplegia pattern. A five-camera VICON 370 system and Vicon Clinical Manager software was used for gait analysis. Kinematic gait analysis revealed excessive pelvic excursion in three of the planes; excessive hip flexion, adduction and internal rotation angles in sagittal, coronal planes and transverse plane, respectively. Twenty-five percent of the children with spastic CP had crouch and 35% had stiff-knee gait pattern. Eighty percent of the analysis (n=34) were resulted in recommendations of a change in patient care. Ninety-five of these recommendations were specific physical therapy regimens, 46% botulinum toxin Type A injections, 49% bracing, and 7% were surgery. In conclusion, gait analysis is a tool that enables the clinicians to differentiate gait deviations, objectively. It serves not only as a measure of treatment outcome, but also as a useful tool in planning ongoing care.
Keywords : Cerebral palsy, gait analysis, rehabilitatio