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Natural Progression of Gait in Children With Cerebral Palsy

Bell, Katharine J. M.S.*; Õunpuu, Sylvia M.Sc.*; DeLuca, Peter A. M.D.*; Romness, Mark J. M.D.


Twenty-eight children with cerebral palsy had two gait analyses an average of 4.4 years apart with no surgical intervention between the tests. The effects of growth and age were examined using three-dimensional kinematics, temporal and stride parameters, and clinical examination measures. Kinematic changes showed decreases in hip, knee, and ankle sagittal plane ranges of motion (ROM), peak hip flexion in swing, and peak knee flexion over time. Temporal and stride parameters showed declines in timing of toe off, cadence, and walking velocity. Clinical measures showed declines in hip abduction ROM (knees flexed and extended), popliteal angle, and sagittal plane ankle ROM (knees flexed and extended). Overall results showed that gait function in these individuals with cerebral palsy decreased longitudinally with respect to temporal/stride measures, passive ROM, and kinematic parameters compared with a group of individuals who had had orthopaedic intervention.

Study conducted at the Center for Motion Analysis at Connecticut Children's Medical Center, Hartford, Connecticut, U.S.A.

From *Center for Motion Analysis, Connecticut Children's Medical Center, Hartford, Connecticut, U.S.A.; and †Commonwealth Orthopaedics and Rehabilitation, Fairfax, Virginia, U.S.A.

Address correspondence and reprint requests to Katharine J. Bell, M.S., Center for Motion Analysis, Connecticut Children's Medical Center, 282 Washington Street, Hartford, CT 06106, U.S.A. (e-mail:

None of the authors received financial support for this study.

© 2002 Lippincott Williams & Wilkins, Inc.