Article

Foot equinus and leg length discrepancy (LLD) are common
problems in hemiplegic cerebral palsy (hCP), both causing secondary deviations of
pelvic motion during gait. It can therefore be assumed that the spinal deviations
observed in hCP patients are secondary as a compensation for the position of the
pelvis arising from the disturbed leg function.
This study investigated the
effects of correcting lower extremity function by orthotics on spinal gait
kinematics in hCP patients. METHODS: Ten adolescent hCP patients and 15 healthy
controls were included. Using a validated and previously used enhanced marker
set, sagittal and frontal plane spinal curvature angles as well as general trunk
and lower extremity kinematics were measured while walking barefoot as well as
with an orthotic correction (only hCP patients) using a 12-camera motion capture
system. RESULTS: The hCP patients in both the barefoot and orthotic conditions
indicated clinically relevant greater lumbar lordosis angles (d>/=0.96,
p/=0.84,
p</=0.142) and
differences in frontal plane lumbar curvature angles (d>/=1.00, p</=0.105)
compared to controls. However, these angles were not influenced by the successful
restoration of a normal heel-to-toe gait pattern and the correction of any LLD
using lower extremity orthotics. CONCLUSIONS: Spinal gait deviations in
adolescents with mild hCP seemed not to result secondarily from foot equinus or
LLD, but probably from structural deformities such as hip flexor contractures.
Future research should address long-term effects of an AFO treatment as well as
the relationship between spinal kinematics and severity of disease.
CI - Copyright (c) 2016 Elsevier B.V. All rights reserved.

Langue : ANGLAIS