Kinematic gait pattern in children with cerebral palsy and leg length discrepancy: Effects of an extra sole

Eek, Meta Nyström; Zügner, Roland; Stefansdottir, Ingibjörg; Tranberg, Roy

doi:10.1016/j.gaitpost.2017.04.022

Cited by 20 publications

(25 citation statements)

References 19 publications

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“…These results are in line with previous findings which revealed that individuals with LLD will alter at the spine, pelvis, and in the lower extremity joints when the short leg sustained a greater proportion of loading rate [ 23 ]. In a study of children with spastic hemiplegia conducted by Eek et al[ 24 ], it was shown that postural stability may change due to the abnormalities with more flexion in the uninvolved leg, short leg compared to the long leg. However, pelvic and/or spinal joints may be distracted and cause a worse problem from this posture as justified by Walsh et al [ 11 ] who revealed that pelvic obliquity is the most common way to compensate leg length discrepancy in the experimental study tested by different heights of shoe rises.…”

Section: Discussionmentioning

confidence: 99%

Leg Length Discrepancy: Dynamic Balance Response during Gait

Azizan

Basaruddin

Salleh

et al. 2018

Journal of Healthcare Engineering

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Balance in the human body's movement is generally associated with different synergistic pathologies. The trunk is supported by one's leg most of the time when walking. A person with poor balance may face limitation when performing their physical activities on a daily basis, and they may be more prone to having risk of fall. The ground reaction forces (GRFs), centre of pressure (COP), and centre of mass (COM) in quite standing posture were often measured for the evaluation of balance. Currently, there is still no experimental evidence or study on leg length discrepancy (LLD) during walking. Analysis of the stability parameters is more representative of the functional activity undergone by the person who has a LLD. Therefore, this study hopes to shed new light on the effects of LLD on the dynamic stability associated with VGRF, COP, and COM during walking. Eighteen healthy subjects were selected among the university population with normal BMIs. Each subject was asked to walk with 1.0 to 2.0 ms−1 of walking speed for three to five trials each. Insoles of 0.5 cm thickness were added, and the thickness of the insoles was subsequently raised until 4 cm and placed under the right foot as we simulated LLD. The captured data obtained from a force plate and motion analysis present Peak VGRF (single-leg stance) and WD (double-leg stance) that showed more forces exerted on the short leg rather than long leg. Obviously, changes occurred on the displacement of COM trajectories in the ML and vertical directions as LLD increased at the whole gait cycle. Displacement of COP trajectories demonstrated that more distribution was on the short leg rather than on the long leg. The root mean square (RMS) of COP-COM distance showed, obviously, changes only in ML direction with the value at 3 cm and 3.5 cm. The cutoff value via receiver operating characteristic (ROC) indicates the significant differences starting at the level 2.5 cm up to 4 cm in long and short legs for both AP and ML directions. The present study performed included all the proposed parameters on the effect of dynamic stability on LLD during walking and thus helps to determine and evaluate the balance pattern.

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Section: Discussionmentioning

confidence: 99%

Leg Length Discrepancy: Dynamic Balance Response during Gait

Azizan

Basaruddin

Salleh

et al. 2018

Journal of Healthcare Engineering

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“…The GMFCS was demonstrated to be highly correlated with the profile and the authors always observed a decrease in the Range of Motion (ROM) of the joints compared to healthy subjects. This abnormal pattern locomotion could lead to increase energy consumption, gait instability and fatigue (Eek et al 2017).…”

Section: Introductionmentioning

confidence: 99%

Gait analysis comparison of two twins: one healthy and one with spastic cerebral palsy

Marchitto

Otmani

Watier

2020

Computer Methods in Biomechanics and Biomedical Engineering

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“…Recent studies have reported that gait deviations occur when LLD is <2 cm (hereafter, mild LLD) [3][4][5]; others have reported LLD as slight as 5-10 mm [6,7]. Two main methodologies evaluating gait asymmetry as a result of LLD have been described in the literature.…”

Section: Introductionmentioning

confidence: 99%

“…The subjects either existed anatomical LLD [8,9] or LLD was acutely simulated with a shoe or heel lift in subjects assumed to have anatomically equal leg lengths [3,7]. Eek et al assessed the impact of mild LLD on pathological gait deviations by correcting gait deviations using a sole lift of 12 mm among children diagnosed with spastic cerebral palsy diplegia and a relatively mild LLD of 16 mm (range 10-28) [5].…”

Section: Introductionmentioning

confidence: 99%

Correlation between Gait Asymmetry and Leg Length Discrepancy—What Is the Role of Clinical Abnormalities?

et al. 2018

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Reducing the effect of leg length discrepancy (LLD) on gait abnormalities while other abnormal conditions such as spasticity, joint contractures or weak muscle strength are exhibited is challenging. This study aimed to evaluate the impact of mild LLD on lower limb biomechanics, on participants with anatomic LLD with and without other clinical abnormalities. A motion capture system was utilized on 32 participants to measure lower limb kinematics and dynamic leg length (DLL) throughout the gait cycle, calculated as the absolute distance from the hip joint center, either to the heel, ankle joint center, or forefoot. The Pearson correlation coefficient found that LLD was associated with 5 kinematic variables only when LLD appeared with no other clinical abnormalities present (r = 0.574 – 0.846, p < 0.05). When clinical abnormalities were present, the random forest classification accuracy was lower (64% versus 80%), implying that the used kinematics are low predictors for anatomic LLD, revealing a higher asymmetrical clearance index (the difference between the maximal stance phase and the minimal contra-lateral swing phase DLL) and a different kinematic variable importance index. Clinical abnormalities in pathological gait will in all probability significantly affect gait deviations, affirming mild anatomic LLD as inconsequential. A functional measurement can offer a better estimate as to the side and extent of the functional discrepancy.

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Kinematic gait pattern in children with cerebral palsy and leg length discrepancy: Effects of an extra sole

Cited by 20 publications

References 19 publications

Leg Length Discrepancy: Dynamic Balance Response during Gait

Leg Length Discrepancy: Dynamic Balance Response during Gait

Gait analysis comparison of two twins: one healthy and one with spastic cerebral palsy

Correlation between Gait Asymmetry and Leg Length Discrepancy—What Is the Role of Clinical Abnormalities?

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