Specific motion patterns of the sagittal, frontal and transversal plane in children with bilateral spastic cerebral palsy: Preliminary results of a cross-sectional study

Introduction: One of the first approaches of gait classif. in children with spast. hemiplegia was publ. in 1987 [1]. This and later approaches were mostly restricted to the motion patterns of the sag. plane [2]. It is required to get knowledge of spec. motion patterns in all planes in patients with cerebral palsy (CP) [3]. 3D-Gait Analysis gives detailed inform. about all 3 planes [4]. The aim of this study is to identify specific motion patterns of children with bilat. spastic CP in all 3 planes.

Methods: This open study up to now includes 8 children with bilat. spast. CP (Level: GMFCS 1–2) without surgical history and before intervent. Botulinumtoxine or oral med.. To evaluate the 3D motion patterns a kinematic motion analysis system is used (VICON, Oxford Metrics, UK), addit. multiplane videografy. Data of angle and angular velocity etc. are analysed. Due to few pat. only descriptive stat. and correlation analysis is reasonable.

Results: Prelim. res. show a pos. correl. between the max. anteversion of the pelvis and the max. flexion of the hip and retroversion of the spine in relation to the pelvis. A lower range of motion in the hip joint is assoc. with a lower range of motion in the knee. The range of motions of pelvic obliquity and spine obliquity is pos. associated. Reduced range of motion in ankle rotat. is assoc. with reduced range of motion in knee rotat.. Ankle: the greater the inversion the greater the internal rotation. In the video-analysis the main role of the pelvis and trunk is clear, without in our present data signif. correlations are to be calculated for this.

Conclusions: Prelim. res. confirmed well known motion patterns in sag. plane, e.g. the pos. association betw. max. anteversion of the pelvis and max. flexion of the hip [2]. Our results indicate that there are specific path. motion patterns after the sag. plane. In particular the lat. tilt of the pelvis and the lat. excursion of the trunk have determining influence on the gait pathology. This knowledge has to flow in onto the treatment of gait disorders in children with CP. Above all the linked consideration of patterns in at least 2 planes can increase the understanding on the effect from therapy and lead to more actual application of these. Moreover by data of further patients we hope to be able to make a contribution.

References: [1] Winters et al, J Bone Joint Surg Am 1987. [2] Berweck & Heinen, Blue Book Botulinumtoxin 2006. [3] Dobson et al, Gait Post 2007. [4] Döderlein & Wolf, Orthopäde 2004