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Gait in 5-year-old children with idiopathic clubfoot

View Article: PubMed Central - PubMed

ABSTRACT

Background and purpose: Idiopathic clubfoot can be bilateral or unilateral; however, most studies of gait have assessed clubfoot cases as one uniform group. The contralateral foot in children with unilateral clubfoot has shown deviations in pedobarographic measurements, but it is seldom included in studies of gait. We evaluated gait in children with idiopathic clubfoot, concentrating on foot involvement.

Patients and methods: Three-dimensional gait analyses of 59 children, mean age 5.4 years, with bilateral (n = 30) or unilateral (n = 29) idiopathic clubfoot were stratified into groups of bilateral, unilateral, or contralateral feet. Age-matched controls (n = 28) were evaluated for comparison. Gait assessment included: (1) discrete kinematic and kinetic parameters, and (2) gait deviation index for kinematics (GDI) and kinetics (GDI-k).

Results: No differences in gait were found between bilateral and unilateral idiopathic clubfoot, but both groups deviated when compared to controls. Compared to control feet, contralateral feet showed no deviations in discrete gait parameters, but discrepancies were evident in relation to unilateral clubfoot, causing gait asymmetries in children with unilateral involvement. However, all groups deviated significantly from control feet according to GDI and GDI-k.

Interpretation: Bilateral and unilateral idiopathic clubfoot cases show the same persistent deviations in gait, mainly regarding reduced plantarflexion. Nevertheless, knowledge of foot involvement is important as children with unilateral clubfoot show gait asymmetries, which might give an impression of poorer deviations. The results of GDI/GDI-k indicate global gait adaptations of the contralateral foot, so the foot should preferably not be used as a reference for gait.

No MeSH data available.


Related in: MedlinePlus

The 95% confidence intervals (CIs) of the mean differences in parameters deviating from the control group in either the Bilat, Unilat, or Contralat group. GDI: gait deviation index; GDI-k: gait deviation index-kinetic. Note that parameters included have different units (degrees, GDI, GDI-k, Nm/kg, and W/kg), so that the 95% CIs and mean differences are not comparable between different parameters, only between groups.
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Figure 0002: The 95% confidence intervals (CIs) of the mean differences in parameters deviating from the control group in either the Bilat, Unilat, or Contralat group. GDI: gait deviation index; GDI-k: gait deviation index-kinetic. Note that parameters included have different units (degrees, GDI, GDI-k, Nm/kg, and W/kg), so that the 95% CIs and mean differences are not comparable between different parameters, only between groups.

Mentions: Statistically significant deviations were found in several parameters across the clubfoot groups compared with controls (Figure 2). Concerning the physical examination, reduced motion was found for dorsiflexion and plantarflexion of the foot and internal rotation of the hip, while an increase in knee extension was observed in the clubfeet (Table 2).


Gait in 5-year-old children with idiopathic clubfoot
The 95% confidence intervals (CIs) of the mean differences in parameters deviating from the control group in either the Bilat, Unilat, or Contralat group. GDI: gait deviation index; GDI-k: gait deviation index-kinetic. Note that parameters included have different units (degrees, GDI, GDI-k, Nm/kg, and W/kg), so that the 95% CIs and mean differences are not comparable between different parameters, only between groups.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5016913&req=5

Figure 0002: The 95% confidence intervals (CIs) of the mean differences in parameters deviating from the control group in either the Bilat, Unilat, or Contralat group. GDI: gait deviation index; GDI-k: gait deviation index-kinetic. Note that parameters included have different units (degrees, GDI, GDI-k, Nm/kg, and W/kg), so that the 95% CIs and mean differences are not comparable between different parameters, only between groups.
Mentions: Statistically significant deviations were found in several parameters across the clubfoot groups compared with controls (Figure 2). Concerning the physical examination, reduced motion was found for dorsiflexion and plantarflexion of the foot and internal rotation of the hip, while an increase in knee extension was observed in the clubfeet (Table 2).

View Article: PubMed Central - PubMed

ABSTRACT

Background and purpose: Idiopathic clubfoot can be bilateral or unilateral; however, most studies of gait have assessed clubfoot cases as one uniform group. The contralateral foot in children with unilateral clubfoot has shown deviations in pedobarographic measurements, but it is seldom included in studies of gait. We evaluated gait in children with idiopathic clubfoot, concentrating on foot involvement.

Patients and methods: Three-dimensional gait analyses of 59 children, mean age 5.4 years, with bilateral (n = 30) or unilateral (n = 29) idiopathic clubfoot were stratified into groups of bilateral, unilateral, or contralateral feet. Age-matched controls (n = 28) were evaluated for comparison. Gait assessment included: (1) discrete kinematic and kinetic parameters, and (2) gait deviation index for kinematics (GDI) and kinetics (GDI-k).

Results: No differences in gait were found between bilateral and unilateral idiopathic clubfoot, but both groups deviated when compared to controls. Compared to control feet, contralateral feet showed no deviations in discrete gait parameters, but discrepancies were evident in relation to unilateral clubfoot, causing gait asymmetries in children with unilateral involvement. However, all groups deviated significantly from control feet according to GDI and GDI-k.

Interpretation: Bilateral and unilateral idiopathic clubfoot cases show the same persistent deviations in gait, mainly regarding reduced plantarflexion. Nevertheless, knowledge of foot involvement is important as children with unilateral clubfoot show gait asymmetries, which might give an impression of poorer deviations. The results of GDI/GDI-k indicate global gait adaptations of the contralateral foot, so the foot should preferably not be used as a reference for gait.

No MeSH data available.


Related in: MedlinePlus