Natural history of gait patterns in untreated children with bilateral cerebral palsy in a low-income country setting

Julie Stebbins; Laurence Wicks; Tim Nunn; Richard Gardner; Tewodros T Zerfu; Mesfin Kassahun; Tim Theologis

doi:10.1111/dmcn.16113

Natural history of gait patterns in untreated children with bilateral cerebral palsy in a low-income country setting

Dev Med Child Neurol. 2024 Oct 11. doi: 10.1111/dmcn.16113. Online ahead of print.

Authors

Julie Stebbins^{1

2}, Laurence Wicks³, Tim Nunn³, Richard Gardner^{4

5}, Tewodros T Zerfu³, Mesfin Kassahun³, Tim Theologis²

Affiliations

¹ Oxford Gait Laboratory, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.
² Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Oxford University, Oxford, UK.
³ Orthopaedic Surgery Department, CURE Children's Hospital of Ethiopia, Addis Ababa, Ethiopia.
⁴ Orthopaedic Surgery Department, Hospital for Sick Children, Toronto, Canada.
⁵ Department of Surgery, University of Toronto, Canada.

PMID: 39392907
DOI: 10.1111/dmcn.16113

Abstract

Aim: To assess a group of ambulant, untreated children with bilateral spastic cerebral palsy, in a resource-poor setting, who had never been assessed by a health care professional or received any treatment, to help establish the natural history of gait patterns in this condition.

Method: At CURE Children's Hospital of Ethiopia, 46 children with no prior health care contact were assessed in a cross-sectional cohort study, through a detailed history, clinical examination, and instrumented gait analysis using a motion capture system.

Results: There was a large spread in the data reflecting the high natural heterogeneity in this population. The severity of gait pathology did not correlate with age; however, a small but significant reduction in sagittal hip and knee range of motion with increasing age was observed. There was also a trend towards reduced passive knee extension with age.

Interpretation: Improved understanding of the aspects of gait that are likely to naturally improve, deteriorate, or remain stable over time helps guide treatment decisions in this population.