Article

This study examined the impact of gait analysis on surgical outcomes in
ambulatory children with cerebral palsy (CP) through a randomized controlled
trial. 156 children with CP (94 male; age 10.2 +/- 3.7 years) underwent gait
analysis and were randomized to two groups: Gait Report group
(N = 83), where the
referring surgeon received the patient's gait analysis report, and Control group
(N = 73), where the surgeon did not receive the gait report. Outcomes were
assessed pre- and 1.3 +/- 0.5 years post-operatively. An intent-to-treat analysis
compared outcomes between the two groups. Outcome measures included the Gillette
Functional Activity Questionnaire (FAQ), Gait Deviation Index (GDI), oxygen cost,
gross motor function measure, Child Health Questionnaire (CHQ), Pediatric
Outcomes Data Collection Instrument (PODCI), and Pediatric Evaluation and
Disability Inventory. The outcomes that differed significantly between groups
were change in health from the CHQ, which was rated as much better for 56%
(46/82) of children in the Gait Report group compared with 38% (28/73) in the
Control group (p = 0.04), and upper extremity physical function from the PODCI.
Gait outcomes (FAQ and GDI) improved more when over half of the recommendations
for a patient were followed or the recommended extent of surgery (none, single,
or multi-level) was done (p </= 0.04). On average, however, only 42% of the
recommendations were followed in the Gait Report group, compared with 35% in the
Control group (p = 0.23).
This is much less than the >85% reported in previous
studies and may account for the lack of differences between groups for some of
the outcome measures.
CI - Copyright (c) 2012 Elsevier B.V. All rights reserved.

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