Instrumented Gait Analysis in the Care of Children with Cerebral Palsy

Abstract

Analysis of a child's gait is an important aspect of a pediatric orthopaedic evaluation. Children with cerebral palsy often have significant gait impairments that negatively impact their ambulation, activity in society, and their quality of life. Instrumented gait analysis, with motion capture, can provide significant data to help the surgeon better understand specific pathophysiology and to plan surgical correction. Modern instrumented gait analysis is comprised of kinematics, kinetics, electromyography, pedobarography, and metabolic assessment. Newer technology allows for wearable measurement devices in the community to provide information about environmental activity, such as step counts, that augment traditional gait analysis. Literature suggests that the use of instrumented gait analysis can be effective in the treatment and care of children with cerebral palsy. Following surgical recommendations from gait analysis can lead to changes in surgical plans derived from physical exam alone, overall fewer surgical procedures, and possibly improved outcomes. Key Concepts: • Gait analysis is an important aspect of a thorough pediatric orthopaedic evaluation. • Children with cerebral palsy have complex gait impairments that need a systematic approach to completely understand the pathophysiology. • Instrumented gait analysis provides significantly additional data to help provide improved understanding of complex gait. • Modern gait laboratories typically include kinematics, kinetics, electromyography, pedobarography, and metabolic assessment. • Literature on the efficacy of instrumented gait analysis is limited, but most reports show improved outcomes and potentially more efficient care if surgical plans recommended by gait analysis are followed.