May assist outcome measures in clinical trials
A retrospective study* of gait analysis data from 49 adults with HSP gathered over a number of years has yielded statistical evidence for grouping HSP gait into four categories in line with an existing gait classification system for children with Cerebral Palsy that has been of benefit in directing treatment.
This classification system may well prove to be of significant value in assessing outcomes and effectiveness of treatments for HSP in clinical trials.
* The Foundation facilitated and funded this study.
Background: Classification of gait in adults with hereditary spastic paresis is limited. Our aim was to use a previously established system to classify gait.
Methods: Forty-nine participants were retrospectively recruited and grouped into existing classifications based on sagittal plane knee joint kinematic data extracted from a 3D analysis. Waveform analysis was used to compare the grouped data to determine if and where differences in the subjective classifications appeared.
Findings: Classification of gait patterns in adults with hereditary spastic paresis is successful. Differences between groups in line with the classification system were confirmed by statistical analysis.
- Crouch gait is illustrated by a flexed knee throughout stance phase.
- Recurvatum gait is dominated by knee hyperextension in mid-late stance.
- Stiff-knee gait demonstrates limited knee range of motion in stance and
- Jump-knee gait is characterised by less knee flexion in early and mid-stance phase than all groups.
Sagittal plane hip and ankle kinematics complement group differences at the knee joint. The jump-knee group is more flexed at the hip than all groups during loading response phase and mid-stance; and the recurvatum group is more extended at the hip than the crouch, jump-knee, and stiff-knee groups during mid and late-stance phase. There is less ankle dorsiflexion throughout stance phase in the recurvatum group than in all other groups.
Interpretation: Sagittal plane knee joint kinematic data can be subjectively used to classify gait features in adults with hereditary spastic paresis. Novel analysis show hip and ankle sagittal plane kinematics can be used to further assist classification.
SOURCE: Clin Biomech (Bristol, Avon). 2022 Dec;100:105793.
doi: 10.1016/j.clinbiomech.2022.105793. Epub 2022 Oct 8.
Gait classification in a population of adults with hereditary spastic paresis
1 Clinical Gait Analysis Service, Monash Health, Victoria, Australia.
2 Clinical Gait Analysis Service, Monash Health, Victoria, Australia.
3 Physiotherapy, Eastern Health, Victoria, Australia.
4 Auckland University of Technology, Auckland, New Zealand.