Article

Excessive pelvic rotation in the transverse plane is common in patients with
cerebral palsy. Knowing the underlying reasons is important for clinical decision
making, since changes in pelvic retraction might have an effect on internally
rotated gait. We hypothesized that the contralateral leg contributes considerably
to pelvic rotation on the retracted side. Therefore the aim of this study is to
calculate predictors for pelvic retraction using both, parameters from the
retracted and from the contralateral protracted side. Thirty-two children with
diplegia and 18 children with hemiplegia were examined by three-dimensional gait
analysis followed by a clinical examination protocol. Stepwise multilinear
regression of the response value mean pelvic retraction during stance phase was
performed on 10 potential predictors of dynamic gait data and 10 corresponding
predictors of clinical data of the retracted and the contralateral protracted
side. Gait analysis revealed ankle push-off energy on the protracted side as the
best predictors in hemiplegic patients explaining 59% of the variance in pelvic
retraction. In diplegic patients external hip rotation of the protracted side was
most accurate in predicting pelvic retraction (27%). Best clinical predictors for
hemiplegic patients were ankle dorsiflexion on the retracted side (46%) and for
diplegic patients it was the knee extension strength on the protracted side
together with hip rotation on the retracted side (36%). In hemiplegic patients
ankle push-off energy of the contralateral side is a significant compensation
mechanism that might cause increased pelvic retraction to compensate for the
weakness of the involved side. In diplegic patients prediction of pelvic
retraction was only moderate and requires further investigation.
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Langue : ANGLAIS