Tuesday, October 27, 2020

Abnormal Gait Patterns In Cerebral Palsy Children

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The following is a list of abnormal gait patterns which may be seen in Cerebral Palsy children and which may need further evaluation:[1]

Antalgic gait (caused by pain)
  • Reduced time spent weight-bearing on the affected side.
  • A multitude of possible causes.
  • A smaller child may just present with unwillingness to weight-bear, so an index of suspicion is required.
  • May be observed in juvenile idiopathic arthritis (JIA), although children do not always complain of pain.
Circumduction gait
  • Excessive hip abduction as the leg swings forwards
  • Typically seen with a leg length discrepancy, with a stiff/restricted joint movement as in JIA, or with unilateral spasticity as in hemiplegic cerebral palsy.
Spastic gait
  • Stiff, foot-dragging with foot inversion. This is often seen in upper motor neurone neurological disease (eg, diplegic or quadriplegic cerebral palsy, stroke).
Ataxic gait
  • Instability with an alternating narrow-to-wide base.
  • Seen in ataxic cerebral palsy affecting the cerebellum, in cerebellar ataxia, and inFriedreich’s ataxia.
Trendelenberg’s gait
  • Results from hip abductor muscle weakness or hip pain. While weight-bearing on the ipsilateral side, the pelvis drops on the contralateral side, rather than rising as is normal. With bilateral hip disease, this leads to a waddling ‘rolling sailor’ gait with hips, knees, and feet externally rotated.
  • May be observed in Legg-Calvé-Perthes disease, slipped upper femoral epiphysis, developmental dysplasia of the hip, arthritis involving the hip, muscle disease (eg, inherited myopathies), and neurological conditions. source

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