Relationship Between Transverse-plane Kinematic Deviations of Lower Limbs and Gait Performance in Children with Unilateral Cerebral Palsy: A Descriptive Analysis

Background: Transverse-plane kinematic deviations of lower limbs are common in children with unilateral cerebral palsy (UCP), often with detrimental consequences for gait. Research question: To identify the most important factor among rotational anomalies of lower limbs for gait in children with UCP. Methods: In a descriptive observational study, 42 children with UCP (age; 5–8 years) who had the ability of independent walking were included. Comprehensive gait analysis was performed and included assessment of the transverse-plane kinematic deviations of the lower limbs [pelvis, hip, and ankle rotation angles, and foot progression (FP) angle], and spatial-temporal gait features [velocity, step length (SL), single-limb support time (SLSt), temporal gait-symmetry index (T-GSI), and spatial gait-symmetry index (S-GSI)]. Results and Significance: The regression analysis indicated that hip rotation was the key determinant of gait velocity (R² = 0.75, P < .001) and S-GSI (R² = 0.24, P = .001). The FP angle was the most important factor for T-GSI (R² = 0.22, P = .002). The ankle rotation explained in part the variance in T-GSI (R² = 0.10, P = .001). Conclusion: Gait velocity and spatial gait-symmetry are primarily affected by hip rotation anomalies. The temporal gait-symmetry is generally associated with the FP angle deviation and partly with ankle rotation deviation.