Relationship between 3D lower limb bone morphology and 3D gait variables in children with uni and bilateral Cerebral Palsy.


Journal

Gait & posture
ISSN: 1879-2219
Titre abrégé: Gait Posture
Pays: England
ID NLM: 9416830

Informations de publication

Date de publication:
02 2022
Historique:
received: 26 08 2020
revised: 27 10 2021
accepted: 06 11 2021
pubmed: 27 11 2021
medline: 15 3 2022
entrez: 26 11 2021
Statut: ppublish

Résumé

Medical and surgical interventions to prevent or reduce bone deformities and improve gait in children with cerebral palsy (CP) are based on empirical evidence that there is a relationship between bone deformities and gait deviations. What is the relationship between tibial-femoral bone morphology and kinematic gait variables in ambulant children with CP? A retrospective analysis was conducted on data from 121 children with uni- (n = 64, mean age 9.9 (SD 3.4) years) and bi- lateral (n = 57, mean age 10.4 (SD 3.6) years) CP who had undergone 3D gait analysis and biplanar X-rays (EOS® system). The limbs were split as DIP (the more impaired limb of children with bilateral CP), HEMI (the impaired limb of unilateral CP) and REF (the unimpaired limb of unilateral CP). Multi-variable Linear Regressions were performed between 23 kinematic variables, the Gait Deviation Index (GDI) and a model composed of nine 3D bone variables for each limb type. When the whole sample was pooled, 72% of R Tibial-femoral bone morphology was only weakly related to kinematic gait variables, in contrast with common clinical assumptions. These results suggest that factors other than bone morphology influence gait quality and thus a thorough clinical examination and gait analysis is required prior to making treatment decisions.

Sections du résumé

BACKGROUND
Medical and surgical interventions to prevent or reduce bone deformities and improve gait in children with cerebral palsy (CP) are based on empirical evidence that there is a relationship between bone deformities and gait deviations.
RESEARCH QUESTION
What is the relationship between tibial-femoral bone morphology and kinematic gait variables in ambulant children with CP?
METHODS
A retrospective analysis was conducted on data from 121 children with uni- (n = 64, mean age 9.9 (SD 3.4) years) and bi- lateral (n = 57, mean age 10.4 (SD 3.6) years) CP who had undergone 3D gait analysis and biplanar X-rays (EOS® system). The limbs were split as DIP (the more impaired limb of children with bilateral CP), HEMI (the impaired limb of unilateral CP) and REF (the unimpaired limb of unilateral CP). Multi-variable Linear Regressions were performed between 23 kinematic variables, the Gait Deviation Index (GDI) and a model composed of nine 3D bone variables for each limb type.
RESULTS
When the whole sample was pooled, 72% of R
SIGNIFICANCE
Tibial-femoral bone morphology was only weakly related to kinematic gait variables, in contrast with common clinical assumptions. These results suggest that factors other than bone morphology influence gait quality and thus a thorough clinical examination and gait analysis is required prior to making treatment decisions.

Identifiants

pubmed: 34826693
pii: S0966-6362(21)00589-0
doi: 10.1016/j.gaitpost.2021.11.011
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

51-59

Informations de copyright

Copyright © 2021 Elsevier B.V. All rights reserved.

Auteurs

Rodolphe Bailly (R)

Fondation Ildys, Brest, France; LATIM, Inserm U1101, Brest, France; Université de Bretagne Occidentale, Brest, France. Electronic address: rodolphe.bailly@ildys.org.

Mathieu Lempereur (M)

LATIM, Inserm U1101, Brest, France; Université de Bretagne Occidentale, Brest, France; Service de Médecine Physique et de Réadaptation, CHRU Brest, France.

Matthias Thepaut (M)

Service de chirurgie infantile, CHRU Brest, France.

Christelle Pons (C)

Fondation Ildys, Brest, France; LATIM, Inserm U1101, Brest, France; Université de Bretagne Occidentale, Brest, France; Service de Médecine Physique et de Réadaptation, CHRU Brest, France.

Laetitia Houx (L)

LATIM, Inserm U1101, Brest, France; Université de Bretagne Occidentale, Brest, France; Service de Médecine Physique et de Réadaptation, CHRU Brest, France.

Sylvain Brochard (S)

Fondation Ildys, Brest, France; LATIM, Inserm U1101, Brest, France; Université de Bretagne Occidentale, Brest, France; Service de Médecine Physique et de Réadaptation, CHRU Brest, France.

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