Gait characteristcs at five gait events in spastic diplegia of cerebral palsy

This study investigated the detailed kinematic characteristics, angular are and peak an pelvis, and the hip, knee and ankle foln's of twenty-three spastic diplegic cerebral palsy (CP) children during level walking by three-dimensional analysis. All motion perameters were systematically and statistically analyzed with emphases on the significance of motion parameters at five specific gait events: heet strike, opposite toe-off, opposite heel strike, toe off and heel strike. According the differerces in the kinematic pattern of the knee in saginal plane, we categorized them into four CP groups: mild, crouch, recurvatum and jump. Through one-way ANOVA statistical analysis, temporal-spatial oarameters and joint angles of the lower extremity were found to be significantly different among four CP groups. For the hip joint angle, the crouch group and a tendency to keep fiexed. And the maximum extension of crouch group was 14.8 degrees of flexion which was significantly lower (p<0.0 other groups. Also, the crouch group had increased hip adduction and internal rototion throughoat the gait cycle. For the ankle joint angle in the sagittal plane, the crouch group had a trend to dorsiflexion and the recurvatum group was to planterflexion. The jump group was similar to normai group of loading response, but it later had a premature piartarflexion at initial stance. For foot progress angle, the jump group shown increased toe-in pattern. Ankle could interfere with the kinematic type of knee joint. If the ankle joint had excessive dorst-flexion during the stance puase of gait cycle, it would easily result in the crouch gait of the knee with crouch. But, if the ankle joint were equinus, it would easily resuit in the genu recurvatum or jump pattern of the knee. The contribution factors of the jump knee gait inchide mayhe not only ankle equinus, but also hurastring spasticity. The jump group demonstrated greater hip flexion la initial stance but later extends to 13.4 degrees. This is noteworthy different to Sutherland's finding.