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Assessment of gait quality and efficiency after undergoing a single-event multilevel surgery in children with cerebral palsy presenting an intoeing gait pattern

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Abstract

Purpose

The biomechanical impact of undergoing a single-event multilevel surgery (SEMLS) for children with cerebral palsy (CP) presenting an intoeing gait pattern has been widely documented. However, past studies mostly focused on gait quality rather than efficiency. Thus, there is a need to determine the impact of undergoing a SEMLS on gait quality and efficiency in children with CP presenting an intoeing gait pattern.

Methods

Data from 16 children with CP presenting an intoeing gait pattern who underwent a SEMLS were retrospectively selected. Gait kinematics was quantified before (baseline) and at least 1 year after the surgery (follow-up). Gait quality was investigated with the Gait Profile Score (GPS), hip internal rotation angle and foot progression angle (FPA). Gait efficiency was analysed using clinically accessible variables, namely the normalised gait speed and medio-lateral and vertical centre of mass excursions (COMp). Dependent variables were compared between sessions with paired t-tests.

Results

At the follow-up, children with CP exhibited a more outward FPA and GPS as well as a decreased hip internal rotation angle. No changes in normalised gait speed and vertical COMp excursion were observed, and medio-lateral COMp excursion was slightly decreased.

Conclusion

Children with CP presenting an intoeing gait pattern who underwent a SEMLS exhibited an increased gait quality, but gait efficiency was only minimally improved at the follow-up compared to baseline. Further studies are needed to identify contributors of gait efficiency in children with CP, and the best treatment modalities to optimise both their gait quality and efficiency.

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Funding

This study was funded by the Fonds de Recherche du Québec-Santé (FRQS) through postdoctoral scholarship received by the first author.

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Authors and Affiliations

  1. Department of Kinesiology, Faculty of Medicine, Laval University, 2325 Rue de l’Université, Québec, QC, G1V 0A6, Canada

    Gabriel Moisan & Katia Turcot

  2. Centre for Interdisciplinary Research in Rehabilitation and Social Integration (CIRRIS), 25 Boulevard Wilfrid-Hamel, Québec, QC, G1M 2S8, Canada

    Gabriel Moisan & Katia Turcot

  3. Kinesiology Laboratory, Geneva University Hospitals and Geneva University, 4 rue Gabrielle-Perret-Gentil CH-1211, Geneva, Switzerland

    Alice Bonnefoy-Mazure, Anne Tabard-Fougère & Stéphane Armand

  4. Service of Pediatric Orthopaedics, Department of Child and Adolescent, Geneva University Hospitals, 4 rue Gabrielle-Perret-Gentil CH-1211, Geneva, Switzerland

    Géraldo De Coulon & Anne Tabard-Fougère

Authors
  1. Gabriel Moisan
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  2. Alice Bonnefoy-Mazure
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  3. Géraldo De Coulon
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  4. Anne Tabard-Fougère
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  5. Stéphane Armand
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  6. Katia Turcot
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Correspondence to Gabriel Moisan.

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Moisan, G., Bonnefoy-Mazure, A., De Coulon, G. et al. Assessment of gait quality and efficiency after undergoing a single-event multilevel surgery in children with cerebral palsy presenting an intoeing gait pattern. Childs Nerv Syst 38, 1523–1530 (2022). https://doi.org/10.1007/s00381-022-05548-x

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  • DOI: https://doi.org/10.1007/s00381-022-05548-x

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