Crouch gait in cerebral palsy

Abstract

The assessment of walking disorders in children has traditionally been performed by observational analysis. Current video imaging and computer techniques allow objective synchronized 3-dimensional joint motion and dynamic electromyographic analysis of complex walking disorders. Computerized gait analysis techniques were used to analyze 46 children with the crouched internally rotated gait pattern of spastic diplegic cerebral palsy. Three groups were identified based on dynamic sagittal plane tilt of the pelvis in 3-dimensional space. Primary anterior tilting represented hip flexor contracture or spasticity. Posterior tilting indicated hamstring related problems. A more balanced pelvis, near normal indicated both groups involved in the crouch pattern. This was compared with clinical examination alone. This demonstrated that dynamic gait analysis was able to differentiate the causes more specifically than clinical examination alone. The Motion Laboratory provides a clinically useful method of assessing the crouch gait in the child with spastic diplegic cerebral palsy.