Turkish Journal of Physical Medicine and Rehabilitation 2009 , Vol 55 , Num 4

Effects of Increased Femoral Anterversion on Gait in Children with Cerebral Palsy

N. Ekin Akalan 1 ,Yener Temelli 2 ,Shavkat Kuchimov 3
1 İstanbul Üniversitesi İstanbul Tıp Fakültesi, Çocuk Sağlığı ve Hastalıkları Anabilim Dalı, İstanbul
2 İstanbul Üniversitesi İstanbul Tıp Fakültesi, Ortopedi ve Travmatoloji Anabilim Dalı, İstanbul
3 Boğaziçi Üniversitesi, Biyomedikal Mühendisliği Enstitüsü, İstanbul, Türkiye

Objective: The aim of this study is to identify the gait deviations due to increased femoral anteversion and to distinguish these deviations from those which are commonly seen in children with spastic diplegic cerebral palsy (SD). 

Materials and Methods: The gait parameters of six neurologically intact children with increased femoral anteversion (NIFA), nine spastic diplegic children with increased femoral anteversion (CPIFA), and fifteen neurologically intact typically developing children (TD) were compared. 3D Motion Analysis System was used to analyze the sagittal plane pelvis, hip, knee, and ankle kinetics and kinematics, as well as the temporo-spatial parameters. 

Results: Increased dorsiflexion and knee flexion at initial contact, increased mean pelvic anterior tilt during stance, decreased peak plantar flexion moment in terminal stance, increased double support time and decreased mean velocity which are the pure effect of SD,  were significantly different in CPIFA group compared to NIFA and TD groups. A strong similarity existed between CPIFA and NIFA groups regarding the increased peak knee extension moment. 

Conclusion: This study supported the hypothesis of “existence of relation between IFA and crouch posture”. The orthopedic surgeons may consider the priority of planning femoral de-rotational osteotomy in surgical treatment schedule for children with CP.

Keywords : Femoral anteversion, cerebral palsy, gait analysis, gait parameters