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ORIGINAL ARTICLE
Year : 2019  |  Volume : 53  |  Issue : 5  |  Page : 655-661

Gait pattern of adults with cerebral palsy and spastic diplegia more than 15 years after being treated with an interval surgery approach: Implications for low-resource settings


1 Department of Surgery, Division of Neurosurgery & Neuroscience Institute, Faculty of Health Sciences, University of Cape Town; Department of Interdisciplinary Health Services, Division of Physiotherapy, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South Africa
2 Department of Physiology, Faculty of Medicine and Nursing, University of the Basque Country, Bilbao, Spain; Department of Human Biology, Division of Exercise Science and Sport Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
3 Department of Surgical Sciences, Division of Orthopaedic Surgery, Faculty of Medicine and Health Sciences, Stellenbosch University; Department of Interdisciplinary Health Services, Division of Community Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South Africa
4 Department of Surgery, Division of Neurosurgery & Neuroscience Institute, Faculty of Health Sciences, University of Cape Town, South Africa
5 Department of Human Biology, Division of Exercise Science and Sport Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town; Department of Surgical Sciences, Division of Orthopaedic Surgery, Faculty of Medicine and Health Sciences, Stellenbosch University, South Africa

Correspondence Address:
Prof. Robert Patrick Lamberts
Department of Surgical Sciences, Division of Orthopaedic Surgery, Stellenbosch University, Tygerberg
South Africa
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ortho.IJOrtho_113_19

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Background: Single-event multilevel surgery (SEMLS) approach is regarded as the golden standard in developed countries to improve gait and functional mobility in children with cerebral palsy (CP). However, this approach is not always feasible in developing countries. Therefore, orthopedic surgery based on an interval surgery approach (ISA) is still commonly used in developing countries, although little is known about the long term outcomes of an ISA. Therefore, the aim of this study was to describe the gait patterns of adults with CP, who have been treated with ISA, which started more than 15 years ago. Materials and Methods: Thirty adults with CP and spastic diplegia, who received ISA treatment 21.6–33.7 years ago, were recruited for this study and participated in three-dimensional gait analysis. Twenty kinematic and nondimensional temporal-distance parameters were captured, while the overall gait deviation index (GDI) was also calculated. Data of the adults with CP were compared to normative data of typically developing (TD) adults. Results: Although all adults with CP were still ambulant, their gait parameters significantly differed from TD adults, with a lower GDI in the adults with CP. The CP gait patterns were characterized by excessive hip flexion and hip internal rotation as well as a stiff-knee gait. Conclusion: Although different to TD adults, the gait patterns observed in the adult with CP treated with ISA is in line with other studies. Gait patterns suggest that derotation osteotomies potentially could have improved the long term gait patterns. Although SEMLS might be the preferred treatment method, potentially resulting in better outcomes, ISA can also be used to treat children with CP in developing countries as India and South Africa, where a SEMLS approach is not always feasible.


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