Article

The identification of gait patterns in cerebral palsy offers a common language
for clinicians and contributes to management algorithms. We describe a
quantitative classification of sagittal gait patterns based on the
plantarflexor-knee extension couple index. This consists of a scatter plot based
on ankle and knee scores, and allows objective identification of the sagittal
gait pattern. Sagittal kinematic data from 200 limbs of 100 patients with
bilateral spastic cerebral palsy were utilized to validate the algorithm against
the assessment of a clinician with expertise in gait pattern identification. A
dataset of 776 cerebral palsy patients, 1552 limbs, was used to compare the
sagittal gait patterns against k-means statistical clustering. The classification
was further explored with respect to the knee kinetics during the middle of
stance and physical examination measurements of the gastrocnemius-soleus complex.
Two supplementary materials (Appendices 2 and 3) provide in-depth discussion
about statistical properties of the plantarflexor-knee extension couple index as
well as its relationship with statistical clustering. The plantarflexor-knee
extension index achieved 98% accuracy and may be suitable for the computational
classification of large patient cohorts and multicentre studies. The sagittal
gait patterns were strongly related to k-means statistical clustering and
physical examination of the gastrocnemius-soleus complex. Patients in crouch gait
had normal soleus and gastrocnemius lengths but spasticity in the gastrocnemius.
Patients in jump gait exhibited a short gastrocnemius and soleus and
gastrocnemius spasticity. Patients in true equinus presented with a moderately
contracted soleus and gastrocnemius and gastrocnemius spasticity. Patients in
apparent equinus did not show abnormal physical examination measurements for the
gastrocnemius-soleus complex.
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Langue : ANGLAIS