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The Progression of Crouch Gait in Diplegic Cerebral Palsy

Cerebral Palsy (CP) is caused by a lesion to the brain that occurs at or near the time of birth. It is the most common cause of motor deficiency in children and occurs in approximately 2 to 3 per 1000 live births. The associated motor deficiency usually leads to spastic muscles, weakness, joint contractures and significantly impacts on gait and mobility.
One of the most common pathological gait patterns in CP is crouch gait, defined as excessive flexion of the knee throughout the stance phase of gait. This inefficient walking pattern often leads to pain and deformities which can contribute to significant deterioration in mobility. However, there is still no clear consensus regarding how this gait develops and progresses which makes identifying the best treatment method challenging.
This prospective study will identify a cohort of children and adults with diplegic CP attending a gait laboratory who demonstrate crouch knee gait. This cohort will be assessed at six monthly intervals over a four-year period. Three-dimensional computerised gait analysis (3DGA) will record gait kinematics and kinetics to assess the degree of crouch gait and the amount of excessive strain on the knee joints. Clinical measures of muscle tightness, body mass index and questionnaire data on daily function and quality of life will also be recorded at each assessment. Physical activity data on time spent sitting, standing and walking will be assessed over a week long period following each assessment using skin mounted ActivPal Professional Physical Activity monitors. This study will monitor how crouch gait progresses in cerebral paly and how this impacts on daily activity and quality of life. Factors likely to cause crouch gait and contribute to its progression will be identified. This should improve the understanding of crouch gait and ultimately lead to improved treatment and outcomes in Cerebral Palsy.