Article

AIM: To examine the impact of age, surgery, and Gross Motor Function
Classification System (GMFCS) level on the prevalence of gait problems in
children with cerebral palsy (CP). METHOD:
Gait analysis records were
retrospectively reviewed for ambulatory patients with CP.
Gait abnormalities were
identified using physical exam and kinematic data. Relationships among age, sex,
previous surgery, GMFCS level, and prevalence of gait abnormalities associated
with crouch and out-toeing, and equinus and in-toeing were assessed using
univariable and multivariable logistic regression. RESULTS: One-thousand and five
records were reviewed. The most common gait problems were in-toeing, excessive
knee flexion, stiff knee, hip flexion, internal rotation, adduction, and equinus
(all >50%). Odds ratios (OR) for various gait problems associated with crouch and
out-toeing increased (OR 1.07-1.32), and those associated with equinus and
in-toeing decreased (OR 0.80-0.94) significantly with increasing age for patients
in GMFCS levels I to III. The same trends were seen with prior surgery (OR for
crouch and out-toeing: 1.86-7.14; OR for equinus and in-toeing: 0.16-0.59).
INTERPRETATION: The prevalence of gait abnormalities varies by GMFCS level, but
similarities exist among levels. The study results suggest that in younger
children, particularly those in GMFCS levels III and IV, treatments for equinus
and in-toeing should be undertaken with caution because these problems tend to
decrease with age even without orthopedic intervention. Such children may end up
with the 'opposite' deformities of calcaneal crouch and out-toeing, which tend to
increase in prevalence with age.
CI - (c) 2016 Mac Keith Press.

Langue : ANGLAIS