The influence of crouch gait on sagittal trunk position and lower lumbar spinal loading in children with cerebral palsy |
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| Affiliation: | 1. MRC-Arthritis Research UK Centre for Integrated Research into Musculoskeletal Ageing (CIMA), Pam Liversidge Building, University of Sheffield, Sheffield S1 3JD, UK;2. Department of Mechanical Engineering, University of Sheffield, Sir Frederick Mappin Building, Sheffield S1 3JD, UK;3. Institute of Neuroscience/Newcastle University Institute for Ageing, Newcastle University, Clinical Ageing Research Unit, Campus for Ageing and Vitality, Newcastle upon Tyne NE4 5PL, UK;4. INSIGNEO Institute for in Silico Medicine, University of Sheffield, Pam Liversidge Building, Sheffield S1 3JD, UK;1. Gait Analysis Laboratory, Central Remedial Clinic, Vernon Avenue, Clontarf, Dublin 3, Ireland;2. School of Physiotherapy, Royal College of Surgeons in Ireland, 123 St Stephens Green, Dublin 2, Ireland;1. Department of Pediatric Orthopaedics, Dana Children''s Hospital, Tel-Aviv Sourasky Medical Center, and the Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel;2. The Gait and Motion Analysis Laboratory, Dana Children''s Hospital, Tel-Aviv Sourasky Medical Center, and the Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel;1. Gait Laboratory, Central Remedial Clinic, Clontarf, Dublin 3, Ireland;2. Trinity Centre for Bioengineering, Parsons Building, Trinity College Dublin, Dublin 2, Ireland;1. Mechanical Engineering, University of Washington, Seattle, WA, United States;2. James R. Gage Center for Gait & Motion Analysis, Gillette Children’s Specialty Healthcare, St. Paul, MN, United States;3. Orthopaedic Surgery, University of Minnesota, Minneapolis, MN, United States;1. Research Group MOVANT, Department of Rehabilitation Sciences and Physiotherapy (REVAKI), University of Antwerp, Wilrijk, Belgium;2. Multidisciplinary Motor Centre Antwerp (M2OCEAN), University of Antwerp, Belgium;3. Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium;4. Department of Paediatrics, Antwerp University Hospital, University of Antwerp, Antwerp, Belgium;5. Clinical Motion Analysis Laboratory, University Hospital Leuven, Pellenberg, Belgium |
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| Abstract: | BackgroundCrouch gait is a common pattern in children with CP. Little investigation has been performed as to the role of the trunk during crouch gait. A compensatory movement of the trunk may alter the position of the ground reaction force with the effect of reducing the moment arm about the knee or hip. While this may benefit these joints in the context of reduced loading, there may be implications further up the kinematic chain at the level of the lumbar spine.Research QuestionAre compensatory movements of the trunk present during crouch gait in children with CP and are levels of loading at the lower lumbar spine affected?MethodsA full barefoot lower limb and trunk 3-dimensional kinematic and kinetic analysis, with kinetics estimated at the spinal position of L5/S1, was performed on 3 groups of children, namely CP Crouch, CP No-Crouch and TD. Differences in trunk position and L5/S1 loading were compared between groups.ResultsMean trunk position in relation to the pelvis and laboratory was not statistically significant between groups. At the level of the spine, no differences were present in mean position between groups for L5/S1 sagittal moment or anterior/posterior force.SignificanceCrouch gait does not elicit a compensatory response of the trunk in children with CP and, consequently, reactive forces and moments at the lower lumbar spine remain within normal limits. With this in mind, it is unlikely that a crouch gait pattern will affect the health of the spine over time in these children. |
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| Keywords: | Cerebral palsy Crouch gait Trunk Inverse dynamics L5/S1 spine |
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