Analysis of Running Gait in Children with Cerebral Palsy: Barefoot vs. a New Ankle Foot Orthosis

Abstract

Running is an essential activity for children with cerebral palsy (CP). This study aims to characterize the locomotor pattern of running in hemiplegic children with new generation ankle foot orthosis (AFOs) conceived to foster intense motor activities such as running. A group of 18 children with spastic hemiplegia was recruited. A biomechanical multivariable comparison was made between barefoot and with AFO running trials. The focus was devoted to bilateral sagittal plane hip, knee, ankle kinematics and kinetics, and three-dimensional ground reaction forces. Wearing the orthoses, the children were found to reduce cadence and the duration of the stance phase as well as increase the step and stride length. The new AFO resulted in significant changes in kinematics of affected ankle both at initial contact 0–3% GC (p < 0.017) and during the entire swing phase 31–100%GC (p < 0.001) being the ankle more dorsiflexed with AFO compared to barefoot condition. Ankle power was found to differ significantly both in absorption and generation 5–10%GC (p < 0.001); 21–27%GC (p < 0.001) with a reduction in both cases when the AFO was worn. No statistical differences were recorded in the GRF components, in the affected ankle torque and hip and knee kinematics and kinetics.

The Effect of a New Generation of Ankle Foot Orthoses on Sloped Walking in Children with Hemiplegia Using the Gait Real Time Analysis Interactive Lab (GRAIL)

“…Gait analysis is mandatory to assess AFOs’ effectiveness. However, limitations arise when using only optoelectronic systems and force platforms, including the inability to pre-determine walking speed, reduced number of analyzed gait cycles, and non-representative lab environments for daily living conditions [ 12 , 13 ].…”

A Novel Procedure for Knee Flexion Angle Estimation Based on Functionally Defined Coordinate Systems and Independent of the Marker Landmarks

“…The angular representation of the motion of a joint is often referred to as "joint kinematics", and it is considered to be highly informative about the performance of the joint and its possible pathological behaviour [11][12][13]. For example, the pathological condition of crouch gait, which is characterized by the permanent flexion of the knees, can be observed in the gait report as an offset in the knee sagittal angle [7,[14][15][16].…”