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Transverse Plane Gait Problems in Children With Cerebral Palsy

Rethlefsen, Susan A. PT*; Kay, Robert M. MD*,†

Journal of Pediatric Orthopaedics: June 2013 - Volume 33 - Issue 4 - p 422–430
doi: 10.1097/BPO.0b013e3182784e16
Cerebral Palsy: Current Issues

Transverse plane deviations are significant contributors to pathologic gait in children with cerebral palsy (CP). Due to limitations in neuromuscular control, balance, strength and coordination, transverse plane gait deviations are poorly tolerated in these children. Transverse plane malalignment results in lever arm dysfunction and can be seen with either intoeing or out-toeing. Frequent causes of transverse plane problems and lever arm dysfunction include long bone (femoral and/or tibial) torsion, pelvic rotation, and pes varus or valgus. Computerized motion analysis facilitates accurate identification of transverse plane abnormalities. This article addresses appropriate identification and treatment of transverse plane gait deviations in children with CP.

*Children’s Orthopaedic Center, Children’s Hospital Los Angeles

Department of Orthopaedic Surgery, Keck-University of Southern California School of Medicine, Los Angeles, CA

The authors declare no conflict of interest.

Reprints: Robert M. Kay, MD, Children’s Orthopaedic Center, Children’s Hospital Los Angeles, 4650 Sunset Blvd., M/S 69, Los Angeles, CA 90027. E-mail:

© 2013 by Lippincott Williams & Wilkins