Case Study 1
This 10 year old boy has cerebral palsy that affects his legs more than his arms (spastic diplegia). He came for a gait analysis because his walking pattern was deteriorating. He was a keen sportsman and was tripping more and beginning to experience sporting injuries. He had had no previous orthopaedic surgery to his legs.
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He had a gait analysis that consisted of an energy test, a clinical examination to look at the length of his muscles and his muscle strength and 3 dimensional gait analysis to record his walking pattern.
The analysis concluded that his main problems were that he was walking with increased bending (flexion) at the hips and knees. That he was walking on his toes and his heels were no longer making contact with the ground. That his knees were turned in towards each other (increased internal rotation of the hips). An increased curvature of his lower spine (pelvic lordosis).
This boy had surgery planned on the basis of that gait analysis. This consisted of:
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bony surgery to realign the thigh bones (distal femoral derotation osteotomies),
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lengthening of the tight hamstring, adductor and calf muscles
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transfer of part of the quadriceps muscles to the hamstrings to help with knee bending (rectus transfer).
In the year post surgery, this boy participated in an extensive physiotherapy rehabilitation program with his local physiotherapist. At 1 year post surgery he was re assessed with gait analysis. At this time, he was walking with a more upright position and with feet flat on the ground. His data on 3 dimensional gait analysis was now close to within the normal range.
