Institutional members access full text with Ovid®

Share this article on:

Position Between Trunk and Pelvis During Gait Depending on the Gross Motor Function Classification System

Sanz-Mengibar, Jose Manuel MPT; Altschuck, Natalie MPT; Sanchez-de-Muniain, Paloma MD, PhD; Bauer, Christian BSc, SS; Santonja-Medina, Fernando MD, PhD

doi: 10.1097/PEP.0000000000000361
Research Reports

Purpose: To understand whether there is a trunk postural control threshold in the sagittal plane for the transition between the Gross Motor Function Classification System (GMFCS) levels measured with 3-dimensional gait analysis.

Method: Kinematics from 97 children with spastic bilateral cerebral palsy from spine angles according to Plug-In Gait model (Vicon) were plotted relative to their GMFCS level.

Results: Only average and minimum values of the lumbar spine segment correlated with GMFCS levels. Maximal values at loading response correlated independently with age at all functional levels. Average and minimum values were significant when analyzing age in combination with GMFCS level.

Conclusion: There are specific postural control patterns in the average and minimum values for the position between trunk and pelvis in the sagittal plane during gait, for the transition among GMFCS I-III levels. Higher classifications of gross motor skills correlate with more extended spine angles.

This paper looks at the trunk positions in children with spastic cerebral palsy, specifically on how the trunk positions change between the Gross Motor Function Classification levels using 3-D kinematics.

Clínica de Rehabilitación Madrid (Mr Sanz-Mengibar and Dr Sanchez-de-Muniain), Madrid, Spain; Vojta Therapy UK (Mr Sanz-Mengibar), London, UK; Technischen Universität (Ms Altschuck) and KBO-Kinderzentrum (Ms Altschuck and Mr Bauer), Munich, Germany; Faculty of Medicine, University of Murcia (Dr Santonja-Medina), and Department of Traumatology, Virgen de la Arrixaca University Hospital (Dr Santonja-Medina), Murcia, Spain.

Correspondence: Jose Manuel Sanz-Mengibar, MPT, Vojta Therapy UK. 113 Gauden Road, London SW4 6LE. London, United Kingdom, and Clínica de Rehabilitación Infantil, Avenida de Valladolid, 31, 28013, Madrid, Spain (

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (

The authors declare no conflicts of interest, and there were no grants or economic help in any part of the development of this study.

Copyright © 2017 Wolters Kluwer Health, Inc. and Section on Pediatrics of the American Physical Therapy Association. All rights reserved.