Transversal Malalignment and Proximal Involvement Play a Relevant Role in Unilateral Cerebral Palsy Regardless the Subtype
Classification of gait disorders in cerebral palsy (CP) remains challenging. The Winters, Gage, and Hicks (WGH) is a commonly used classification system for unilateral CP regarding the gait patterns (lower limb kinematics) solely in the sagittal plane. Due to the high number of unclassified patients...
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| Format: | Article |
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MDPI AG
2022-08-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/11/16/4816 |
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| author | Stefanos Tsitlakidis Sarah Campos Nicholas A. Beckmann Sebastian I. Wolf Sébastien Hagmann Tobias Renkawitz Marco Götze |
| author_facet | Stefanos Tsitlakidis Sarah Campos Nicholas A. Beckmann Sebastian I. Wolf Sébastien Hagmann Tobias Renkawitz Marco Götze |
| author_sort | Stefanos Tsitlakidis |
| collection | DOAJ |
| description | Classification of gait disorders in cerebral palsy (CP) remains challenging. The Winters, Gage, and Hicks (WGH) is a commonly used classification system for unilateral CP regarding the gait patterns (lower limb kinematics) solely in the sagittal plane. Due to the high number of unclassified patients, this classification system might fail to depict all gait disorders accurately. As the information on trunk/pelvic movements, frontal and transverse planes, and kinetics are disregarded in WGH, 3D instrumented gait analysis (IGA) for further characterization is necessary. The objective of this study was a detailed analysis of patients with unilateral CP using IGA taking all planes/degrees of freedom into account including pelvic and trunk movements. A total of 89 individuals with unilateral CP matched the inclusion criteria and were classified by WGH. Subtype-specific differences were analyzed. The most remarkable findings, in addition to the established WGH subtype-specific deviations, were pelvic obliquity and pelvic retraction in all WGH types. Furthermore, the unclassified individuals showed altered hip rotation moments and pelvic retraction almost throughout the whole gait cycle. Transversal malalignment and proximal involvement are relevant in all individuals with unilateral CP. Further studies should focus on WGH type-specific rotational malalignment assessment (static vs. dynamic, femoral vs. tibial) including therapeutic effects and potential subtype-specific compensation mechanisms and/or tertiary deviations of the sound limb. |
| first_indexed | 2024-03-09T09:55:45Z |
| format | Article |
| id | doaj.art-d038853e9bda4475b4f8c7472c206e59 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-09T09:55:45Z |
| publishDate | 2022-08-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-d038853e9bda4475b4f8c7472c206e592023-12-01T23:50:41ZengMDPI AGJournal of Clinical Medicine2077-03832022-08-011116481610.3390/jcm11164816Transversal Malalignment and Proximal Involvement Play a Relevant Role in Unilateral Cerebral Palsy Regardless the SubtypeStefanos Tsitlakidis0Sarah Campos1Nicholas A. Beckmann2Sebastian I. Wolf3Sébastien Hagmann4Tobias Renkawitz5Marco Götze6Department of Orthopaedics, Heidelberg University Hospital, Landstrasse 200a, 69118 Heidelberg, GermanyDepartment of Orthopaedics, Heidelberg University Hospital, Landstrasse 200a, 69118 Heidelberg, GermanyDepartment of Orthopaedics, Heidelberg University Hospital, Landstrasse 200a, 69118 Heidelberg, GermanyDepartment of Orthopaedics, Heidelberg University Hospital, Landstrasse 200a, 69118 Heidelberg, GermanyDepartment of Orthopaedics, Heidelberg University Hospital, Landstrasse 200a, 69118 Heidelberg, GermanyDepartment of Orthopaedics, Heidelberg University Hospital, Landstrasse 200a, 69118 Heidelberg, GermanyDepartment of Orthopaedics, Heidelberg University Hospital, Landstrasse 200a, 69118 Heidelberg, GermanyClassification of gait disorders in cerebral palsy (CP) remains challenging. The Winters, Gage, and Hicks (WGH) is a commonly used classification system for unilateral CP regarding the gait patterns (lower limb kinematics) solely in the sagittal plane. Due to the high number of unclassified patients, this classification system might fail to depict all gait disorders accurately. As the information on trunk/pelvic movements, frontal and transverse planes, and kinetics are disregarded in WGH, 3D instrumented gait analysis (IGA) for further characterization is necessary. The objective of this study was a detailed analysis of patients with unilateral CP using IGA taking all planes/degrees of freedom into account including pelvic and trunk movements. A total of 89 individuals with unilateral CP matched the inclusion criteria and were classified by WGH. Subtype-specific differences were analyzed. The most remarkable findings, in addition to the established WGH subtype-specific deviations, were pelvic obliquity and pelvic retraction in all WGH types. Furthermore, the unclassified individuals showed altered hip rotation moments and pelvic retraction almost throughout the whole gait cycle. Transversal malalignment and proximal involvement are relevant in all individuals with unilateral CP. Further studies should focus on WGH type-specific rotational malalignment assessment (static vs. dynamic, femoral vs. tibial) including therapeutic effects and potential subtype-specific compensation mechanisms and/or tertiary deviations of the sound limb.https://www.mdpi.com/2077-0383/11/16/4816unilateral cerebral palsygait classification3D instrumented gait analysisgait kinematicsjoint moments |
| spellingShingle | Stefanos Tsitlakidis Sarah Campos Nicholas A. Beckmann Sebastian I. Wolf Sébastien Hagmann Tobias Renkawitz Marco Götze Transversal Malalignment and Proximal Involvement Play a Relevant Role in Unilateral Cerebral Palsy Regardless the Subtype Journal of Clinical Medicine unilateral cerebral palsy gait classification 3D instrumented gait analysis gait kinematics joint moments |
| title | Transversal Malalignment and Proximal Involvement Play a Relevant Role in Unilateral Cerebral Palsy Regardless the Subtype |
| title_full | Transversal Malalignment and Proximal Involvement Play a Relevant Role in Unilateral Cerebral Palsy Regardless the Subtype |
| title_fullStr | Transversal Malalignment and Proximal Involvement Play a Relevant Role in Unilateral Cerebral Palsy Regardless the Subtype |
| title_full_unstemmed | Transversal Malalignment and Proximal Involvement Play a Relevant Role in Unilateral Cerebral Palsy Regardless the Subtype |
| title_short | Transversal Malalignment and Proximal Involvement Play a Relevant Role in Unilateral Cerebral Palsy Regardless the Subtype |
| title_sort | transversal malalignment and proximal involvement play a relevant role in unilateral cerebral palsy regardless the subtype |
| topic | unilateral cerebral palsy gait classification 3D instrumented gait analysis gait kinematics joint moments |
| url | https://www.mdpi.com/2077-0383/11/16/4816 |
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