Effects of artificially induced bilateral internal rotation gait on gait kinematics and kinetics.

Artificially induced internal rotation gait Bilateral internal rotation gait Children Frontal hip moments Rotation bandage

Journal

Gait & posture
ISSN: 1879-2219
Titre abrégé: Gait Posture
Pays: England
ID NLM: 9416830

Informations de publication

Date de publication:
06 2022
Historique:
received: 19 09 2021
revised: 20 04 2022
accepted: 02 05 2022
pubmed: 10 5 2022
medline: 31 5 2022
entrez: 9 5 2022
Statut: ppublish

Résumé

Bilateral internal rotation gait is a common gait abnormality in children with bilateral cerebral palsy, but still not fully understood. The aim of this clinical study was to analyze the effects of artificially induced bilateral internal rotation gait on kinematics and kinetics. Our hypothesis was, that the internal rotation gait defined as increased dynamic internal hip rotation itself causes significant alterations in gait kinematics and kinetics. 30 typically developing children with a mean age of 12 (SD 3) years (range 8 - 16) performed three-dimensional gait analysis in two different conditions: with unaffected gait and with artificially induced bilateral internal rotation gait with two rotation bandages worn in order to internally rotate the hips. Kinematic and kinetic changes between these two conditions were calculated and compared using a mixed linear model with "gait condition" as fixed effect and both "limb" and "patient" as random effects. The rotation bandages induced a significant increase in internal hip rotation and foot progression angle towards internal without affecting pelvic rotation. The peak hip internal rotator moment during loading response and the peak hip external rotator moment during the first half of stance phase increased significantly and the peak hip internal rotator moment during the second half of stance phase decreased significantly. Anterior pelvic tilt, hip flexion, knee flexion and ankle dorsiflexion increased significantly. The first peak of the frontal hip moment decreased, and the second increased significantly. The second peak of the frontal knee moment decreased significantly, while the first didn't change significantly. The data suggest, that the bilaterally increased dynamic internal hip rotation itself has a relevant impact on frontal hip moments. The increased anterior pelvic tilt, hip and knee flexion may be either induced by the pull of the rotation bandage or a secondary gait deviation.

Sections du résumé

BACKGROUND
Bilateral internal rotation gait is a common gait abnormality in children with bilateral cerebral palsy, but still not fully understood.
RESEARCH QUESTION
The aim of this clinical study was to analyze the effects of artificially induced bilateral internal rotation gait on kinematics and kinetics. Our hypothesis was, that the internal rotation gait defined as increased dynamic internal hip rotation itself causes significant alterations in gait kinematics and kinetics.
METHODS
30 typically developing children with a mean age of 12 (SD 3) years (range 8 - 16) performed three-dimensional gait analysis in two different conditions: with unaffected gait and with artificially induced bilateral internal rotation gait with two rotation bandages worn in order to internally rotate the hips. Kinematic and kinetic changes between these two conditions were calculated and compared using a mixed linear model with "gait condition" as fixed effect and both "limb" and "patient" as random effects.
RESULTS
The rotation bandages induced a significant increase in internal hip rotation and foot progression angle towards internal without affecting pelvic rotation. The peak hip internal rotator moment during loading response and the peak hip external rotator moment during the first half of stance phase increased significantly and the peak hip internal rotator moment during the second half of stance phase decreased significantly. Anterior pelvic tilt, hip flexion, knee flexion and ankle dorsiflexion increased significantly. The first peak of the frontal hip moment decreased, and the second increased significantly. The second peak of the frontal knee moment decreased significantly, while the first didn't change significantly.
SIGNIFICANCE
The data suggest, that the bilaterally increased dynamic internal hip rotation itself has a relevant impact on frontal hip moments. The increased anterior pelvic tilt, hip and knee flexion may be either induced by the pull of the rotation bandage or a secondary gait deviation.

Identifiants

pubmed: 35533614
pii: S0966-6362(22)00126-6
doi: 10.1016/j.gaitpost.2022.05.003
pii:
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

204-209

Informations de copyright

Copyright © 2022 Elsevier B.V. All rights reserved.

Auteurs

Mirjam Thielen (M)

University Hospital Heidelberg, Clinic for Orthopedic and Trauma Surgery, Schlierbacher Landstr. 200a, 69115 Heidelberg, Germany; BG Klinik Ludwigshafen, Department of Hand, Plastic and Reconstructive Surgery, Burn Center, Plastic and Hand Surgery, Ludwig-Guttmann-Str. 13, 67071 Ludwigshafen am Rhein, Germany. Electronic address: mirjam.thielen@bgu-ludwigshafen.de.

Dorothea Waible (D)

University Hospital Heidelberg, Clinic for Orthopedic and Trauma Surgery, Schlierbacher Landstr. 200a, 69115 Heidelberg, Germany. Electronic address: dorothea.waible@med.uni-heidelberg.de.

Britta K Krautwurst (BK)

University Hospital Heidelberg, Clinic for Orthopedic and Trauma Surgery, Schlierbacher Landstr. 200a, 69115 Heidelberg, Germany; University Children's Hospital Zurich, Department of Pediatric Orthopedics, Steinwiesstr. 75, 8032 Zürich, Switzerland. Electronic address: britta.krautwurst@kispi.uzh.ch.

Sebastian I Wolf (SI)

University Hospital Heidelberg, Clinic for Orthopedic and Trauma Surgery, Schlierbacher Landstr. 200a, 69115 Heidelberg, Germany. Electronic address: sebastian.wolf@med.uni-heidelberg.de.

Thomas Dreher (T)

University Hospital Heidelberg, Clinic for Orthopedic and Trauma Surgery, Schlierbacher Landstr. 200a, 69115 Heidelberg, Germany; University Children's Hospital Zurich, Department of Pediatric Orthopedics, Steinwiesstr. 75, 8032 Zürich, Switzerland. Electronic address: thomas.dreher@kispi.uzh.ch.

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