Classification of Gait Patterns in Cerebral Palsy
Introduction[edit | edit source]
This page will look at the different types of gait patterns found in people with cerebral palsy, the use of orthosis and the background of use, and interventions which might be used.
Gait Patterns [edit | edit source]
There are a couple of different common gait patterns found in people with cerebral palsy which will be covered in a little more detail below. This page will focus on:
- Spastic Hemiplegia / Unilateral CP
- Bilateral Spastic CP
It will them focus on the different types of gait patterns found within these two groups.
Spastic Hemiplegia / Unilateral CP[edit | edit source]
The most widely accepted classification of gait in spastic hemiplegia is that reported by Winters et al. (1987). They subdivided hemiplegia into four gait patterns based on sagittal plane kinematics. The classification has direct relevance to understanding the gait pattern and management.
- Type 1 –weak or paralysed/silent dorsiflexors (= dropfoot)
- Type 2 – type 1 + triceps surae contracture
- Type 3 – type 2 + hamstrings and/or Rectus Femoris spasticity
- Type 4 – type 3 + spastic hip flexors and adductors
Type 1 Hemiplegia[edit | edit source]
In Type 1 hemiplegia there is a `drop foot' which is noted most clearly in the swing phase of gait, due to inability to selectively control the ankle dorsiflexors during this part of the gait cycle. There is no calf contracture and therefore during stance phase, ankle dorsiflexion is relatively normal. In the experience of the author, this gait pattern is rare, unless there has already been a calf lengthening procedure. The only management maybe needed is a leaf spring or hinged ankle foot orthosis (AFO). Spasticity management and contracture surgery are clearly not required.
- Orthotic management: Leaf spring or hinged AFO.
Type 2 hemiplegia
