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Gait classification in a population of adults with hereditary spastic paresis

      Highlights

      • This study shows gait categorisation alongside statistical parametric mapping analysis.
      • Gait of adults with hereditary spastic paraplegia can be classified by lower limb kinematics.
      • Recognisable gait descriptors provide a way to monitor changes & inform management.

      Abstract

      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 compliment 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.

      Keywords

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      References

        • Alton F.
        • Baldey L.
        • Caplan S.
        • Morrissey M.
        A kinematic comparison of overground and treadmill walking.
        Clin. Biomech. 1998; 13: 434-440
        • Cimolin V.
        • Piccinini L.
        • D’Angelo M.G.
        • Turconi A.C.
        Are patients with hereditary spastic paraplegia different from patients with spastic diplegia during walking? Gait evaluation using 3D gait analysis.
        Funct. Neurol. 2007; 22: 23
        • Dobson F.
        • Morris M.E.
        • Baker R.
        • Graham H.K.
        Gait classification in children with cerebral palsy: a systematic review.
        Gait Posture. 2007; 25: 140-152
        • Erichsen A.K.
        • Koht J.
        • Stray-Pedersen A.
        • Abdelnoor M.
        • Tallaksen C.M.
        Prevalence of hereditary ataxia and spastic paraplegia in Southeast Norway: a population-based study.
        Brain. 2009; 132: 1577-1588
        • Fink J.K.
        Hereditary spastic paraplegia.
        Curr. Neurol. Neurosci. Rep. 2006; 6: 65-76
        • Kadaba M.P.
        • Ramakrishnan H.K.
        • Wootten M.E.
        • Gainey J.
        • Gorton G.
        • Cochran G.V.B.
        Repeatability of kinematic, kinetic, and electromyographic data in normal adult gait.
        J. Ohopaedic Res. 1989; 7: 849-860
        • Klebe S.
        • Stolze H.
        • Kopper F.
        • Lorenz D.
        • Wenzelburger R.
        • Volkmann J.
        • et al.
        Gait analysis of sporadic and hereditary spastic paraplegia.
        J. Neurol. 2004; 251: 571-578
        • McGinley J.L.
        • Baker R.
        • Wolfe R.
        • Morris M.E.
        The reliability of three-dimensional kinematic gait measurements: a systematic review.
        Gait Posture. 2009; 29: 360-369
        • Molteni F.
        • Carda S.
        • Cazzaniga M.
        • Magoni L.
        • Rossini M.
        • Caimmi M.
        Instrumental evaluation of gait modifications before and during intrathecal baclofen therapy: a 2-year follow-up case study.
        Am. J. Phys. Med. Rehabil. 2005; 84: 303-306
        • Nielsen J.E.
        • Krabbe K.
        • Jennum P.
        • Koefoed P.
        • Jensen L.N.
        • Fenger K.
        • et al.
        Autosomal dominant pure spastic paraplegia: a clinical, paraclinical, and genetic study.
        J. Neurol. Neurosurg. Psychiatry. 1998; 64: 61-66
        • Pataky T.
        Generalized n-dimensional biomechanical field analysis using statistical parametric mapping.
        J. Biomech. 2010; 43: 1976-1982
        • Piccinini L.
        • Cimolin V.
        • D’Angelo M.G.
        • Turconi A.C.
        • Crivellini M.
        • Galli M.
        3D gait analysis in patients with hereditary spastic paraparesis and spastic diplegia: a kinematic, kinetic and EMG comparison.
        Eur. J. Paediatr. Neurol. 2011; 15: 138-145
        • Rodda J.
        • Graham H.
        • Carson L.
        • Galea M.
        • Wolfe R.
        Sagittal gait patterns in spastic diplegia.
        J. Bone Joint Surg. 2004; 86: 251-258
        • Serrao M.
        • Rinaldi M.
        • Ranavolo A.
        • Lacquaniti F.
        • Martino G.
        • Leonardi L.
        • et al.
        Gait patterns in patients with hereditary spastic paraparesis.
        PLoS One. 2016; 11e0164623
        • Sutherland D.H.
        • Davids J.R.
        Common gait abnormalities of the knee in cerebral palsy.
        Clin. Orthop. Relat. Res. 1993; : 139-147
        • Watt J.R.
        • Franz J.R.
        • Jackson K.
        • Dicharry J.
        • Riley P.O.
        • Kerrigan D.C.
        A three-dimensional kinematic and kinetic comparison of overground and treadmill walking in healthy elderly subjects.
        Clin. Biomech. 2010; 25: 444-449
        • Williams G.
        • Willmott C.
        Higher levels of mobility are associated with greater societal participation and better quality-of-life.
        Brain Inj. 2012; 26: 1065-1107
        • Williams G.
        • Morris M.E.
        • Schache A.
        • McCrory P.R.
        Incidence of gait abnormalities after traumatic brain injury.
        Arch. Phys. Med. Rehabil. 2009; 90: 587-593
        • Winters T.
        • Gage J.
        • Hicks R.
        Gait patterns in spastic hemiplegia in children and young adults.
        J. Bone Joint Surg. 1987; 69: 437-441
        • Wolf S.I.
        • Braatz F.
        • Metaxiotis D.
        • Armbrust P.
        • Dreher T.
        • Döderlein L.
        • et al.
        Gait analysis may help to distinguish hereditary spastic paraplegia from cerebral palsy.
        Gait Posture. 2011; 33: 556-561