Natural history of gait patterns in untreated children with bilateral cerebral palsy in a low-income country setting.
Julie Stebbins, Laurence Wicks, Tim Nunn and 4 others
PMID 39392907WHAT IT FOUND
Untreated children with bilateral cerebral palsy show highly variable gait patterns, but hip and knee movement ranges decrease with age.
This supports prioritizing interventions to maintain hip and knee extension, rather than assuming a uniform progression from equinus to crouch gait.
Key findings
01Overall gait abnormality (Gait Profile Score) and walking speed did not significantly change with age in untreated children.
02Hip and knee flexion ranges during gait significantly decreased with age, while other variables like ankle dorsiflexion and hip adduction did not show clear age-related changes.
03Gait patterns were highly heterogeneous, with no clear trend in foot posture or passive joint range of motion changing with age across the cohort.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
The study is cross-sectional, not longitudinal, so it cannot definitively track individual changes over time. Participants were referred to a gait laboratory, largely reflecting those being considered for orthopaedic surgery, which may bias the sample toward more severe cases. The sample size (46 children) is relatively small, which may limit the power to detect smaller age-related trends. Diagnosis of cerebral palsy was based on history, as brain MRI is not routinely available in Ethiopia. Comparison with literature is difficult due to differences in aetiology, environment, and resource availability between the study setting and developed healthcare contexts.
Declared interests
The study was conducted in collaboration with the Oxford Gait Laboratory. No specific funding sources or author conflicts of interest are detailed in the provided text beyond the institutional collaboration.
The easy way to misread this
Do not assume that the lack of change in overall Gait Profile Score with age means gait pathology does not progress. The study found significant decreases in hip and knee flexion ranges with age, indicating specific kinematic deterioration despite stable global scores.