Kinematic Changes throughout Childhood in Youth with Cerebral Palsy: Influence of Age and Orthopaedic Surgery

Abstract

Background: Abnormal gait kinematics are common in youth with cerebral palsy (CP), but prior studies have not analyzed their longitudinal change throughout childhood. This study examines how age and orthopaedic surgery influence gait kinematics throughout childhood in those with ambulatory CP. Methods: In this institutional review board-approved prospective cohort study, children with spastic CP (GMFCS I–III) were recruited at age 17–40 months. Instrumented gait analysis was performed at 3-year intervals from age 4 to 21 years, collecting longitudinal kinematic data in bare feet at a self-selected speed. The change in Gait Profile Score (ΔGPS) between each pair of gait analyses (intervals) was analyzed by age distribution (p = 0.0004). Surgical intervals had significantly greater GPS improvement in the 15-year-old groups, p = 0.0063. Conclusions: Improvement in gait kinematics in children with CP is significantly influenced by age and timing of orthopaedic surgical intervention for gait correction, and was most pronounced for children 10 years old. These results reinforce the importance of considering the timing of orthopaedic surgery.

Keywords

• gait
• kinematics
• cerebral palsy
• multilevel surgery