Factors associated with pelvic retraction during gait in cerebral palsy

O’Sullivan, Rory; Walsh, Mike; Jenkinson, A.; OʼBrien, Timothy M.

doi:10.1016/j.gaitpost.2006.05.004

Cited by 31 publications

(45 citation statements)

References 19 publications

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“…Children with hemiplegia or Unilateral Spastic Cerebral Palsy (USCP) [2] often walk with abnormal pelvic motion patterns and reported deviations include increased anterior pelvic tilt [1,3], retraction of the affected side [4][5][6][7] and contralateral pelvic drop (Trendelenburg gait) [8]. These alterations can occur as a result of one or a combination of different variables such as weakness, skeletal deformities, abnormal muscle activation patterns, leg length discrepancy and compensatory mechanisms.…”

Section: Introductionmentioning

confidence: 99%

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Pelvic kinematics and their relationship to gait type in hemiplegic cerebral palsy

et al. 2011

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Section: Introductionmentioning

confidence: 99%

“…In the transverse plane, O'Sullivan and colleagues [5] found 46% of children with USCP walked with the hemipelvis excessively retracted, i.e. more than 2 standard deviations from their normal database (<À4.838) and concluded that this was associated with secondary problems of clinical and dynamic tightness of the calf musculature.…”

Section: Introductionmentioning

confidence: 99%

Pelvic kinematics and their relationship to gait type in hemiplegic cerebral palsy

et al. 2011

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“…The pelvis protracts to the side where the limb advances during swing and it retracts at the same time on the opposite side. Excessive pelvic retraction is common in patients with cerebral palsy; the prevalence is 46% and 30% in hemiplegic and diplegic patients, respectively [2].…”

Section: Introductionmentioning

confidence: 99%

“…Spinal malformation might be another cause of pelvic retraction. Recent studies in hemi and diplegic patients suggest that it is a deformity due to functional impairments in the limbs [2,[8][9][10][11].…”

Section: Introductionmentioning

confidence: 99%

“…In hemiplegic patients, analyses of dynamic gait parameters [2,8] as well as computer simulations [9] demonstrated increased pelvic retraction resulting from eccentric muscle response to abnormal loading or fixed contracture of the triceps surae muscles. This is in agreement with pre-and postoperative gait data showing a reduction in amount of pelvic retraction when the triceps surae Gait & Posture 35 (2012) [250][251][252][253][254] Excessive pelvic rotation in the transverse plane is common in patients with cerebral palsy.…”

Section: Introductionmentioning

confidence: 99%

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Predictors of pelvic retraction in children with cerebral palsy derived from gait parameters and clinical testing

et al. 2012

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The knee kinematic pattern associated with disruption of the knee extensor mechanism in ambulant patients with diplegic cerebral palsy

et al. 2010

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Failure of the knee extensor mechanism is a potentially disastrous complication of diplegic cerebral palsy and if left undiagnosed may lead to a cessation of independent walking. The disruption of the extensor mechanism usually occurs through or distal to the patella. The aim of this article is to describe the knee kinematic pattern associated with such knee pathology. We also present a mathematical model of knee crouch that leads to this problem. In a retrospective review of patients with radiographically proven disruption, we compared the postfailure clinical and kinematic data to premorbid data. All patients included in this study had attended our clinical Gait Analysis Laboratory on two occasions. In the patients with disruption of the extensor mechanism, the kinematic pattern changed from crouch with shock absorption to one of increased crouch and loss of shock absorption. Clinical characteristics included knee flexion contracture and increased hamstring tightness. We demonstrate how the prefailure crouch position of the knee increases the flexor moment arm about the knee. We suggest that this knee crouch position during walking is the primary cause of pathology. Failure of the knee extensor mechanism is associated with a distinctive knee kinematic pattern. Regular gait analysis can help identify this pathology and enable treatment to be planned accordingly.

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Factors associated with pelvic retraction during gait in cerebral palsy

Cited by 31 publications

References 19 publications

Pelvic kinematics and their relationship to gait type in hemiplegic cerebral palsy

Pelvic kinematics and their relationship to gait type in hemiplegic cerebral palsy

Predictors of pelvic retraction in children with cerebral palsy derived from gait parameters and clinical testing

The knee kinematic pattern associated with disruption of the knee extensor mechanism in ambulant patients with diplegic cerebral palsy

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