Article

Elevated kinematic variability of the foot and ankle segments exists
during gait among individuals with equinovarus secondary to hemiplegic cerebral
palsy (CP). Clinicians have previously addressed such variability by developing
classification schemes to identify subgroups of individuals based on their
kinematics. OBJECTIVE: To identify kinematic subgroups among youth with
equinovarus secondary to CP using 3-dimensional multi-segment foot and ankle
kinematics during locomotion as inputs for principal component analysis (PCA),
and K-means cluster analysis. METHODS: In a single assessment session,
multi-segment foot and ankle kinematics using the Milwaukee Foot Model (MFM) were
collected in 24 children/adolescents with equinovarus and 20 typically developing
children/adolescents.
RESULTS: PCA was used as a data reduction technique on 40
variables. K-means cluster analysis was performed on the first six principal
components (PCs) which accounted for 92% of the variance of the dataset. The PCs
described the location and plane of involvement in the foot and ankle. Five
distinct kinematic subgroups were identified using K-means clustering.
Participants with equinovarus presented with variable involvement ranging from
primary hindfoot or forefoot deviations to deformtiy that included both segments
in multiple planes. CONCLUSION: This study provides further evidence of the
variability in foot characteristics associated with equinovarus secondary to
hemiplegic CP. These findings would not have been detected using a single segment
foot model. The identification of multiple kinematic subgroups with unique foot
and ankle characteristics has the potential to improve treatment since similar
patients within a subgroup are likely to benefit from the same intervention(s).
CI - Copyright (c) 2014 Elsevier B.V. All rights reserved.

Langue : ANGLAIS