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Article

Assessing Gross Motor and Gait Function Using Hip–Knee Cyclograms in Ambulatory Children with Spastic Cerebral Palsy

1
Department of Rehabilitation Medicine, Gachon University Gil Medical Center, College of Medicine, Gachon University, Incheon 21565, Republic of Korea
2
Department and Research Institute of Rehabilitation Medicine, College of Medicine, Yonsei University, Seoul 03722, Republic of Korea
*
Author to whom correspondence should be addressed.
Sensors 2025, 25(14), 4485; https://doi.org/10.3390/s25144485
Submission received: 2 June 2025 / Revised: 14 July 2025 / Accepted: 17 July 2025 / Published: 18 July 2025
(This article belongs to the Section Physical Sensors)

Abstract

Weakness, spasticity, and muscle shortening are common in children with cerebral palsy (CP), leading to deficits in gross motor, gait, and selective motor functions. While traditional assessments, such as the Gross Motor Function Measure (GMFM-66), instrumented gait analysis, and the Selective Control Assessment of the Lower Extremity (SCALE), are widely used, they are often limited by the resource-intensive nature of hospital-based evaluations. We employed cyclogram-based analysis, utilizing simple hip and knee joint kinematics to assess clinical measures, including GMFM-66, normalized gait speed, the gait deviation index (GDI), and the gait profile score (GPS). Principal component analysis was used to quantify the cyclogram shape characteristics. A total of 144 children with ambulatory spastic CP were included in the study. All the cyclogram parameters were significantly correlated with GMFM-66, gait speed, the GDI, and the sagittal plane subscore of the GPS for the hip and knee, with the swing phase area showing the strongest correlation. Regression models based on the swing phase area were used to estimate the GMFM-66 (R2 = 0.301) and gait speed (R2 = 0.484). The PC1/PC2 ratio showed a moderate correlation with selective motor control, as measured by the SCALE (R2 = 0.320). These findings highlight the potential of hip–knee cyclogram parameters to be used as accessible digital biomarkers for evaluating motor control and gait function in children with bilateral spastic CP. Further prospective studies using wearable sensors, such as inertial measurement units, are warranted to validate and build upon these results.
Keywords: cerebral palsy; gross motor function; gait function; cyclogram; digital-biomarker cerebral palsy; gross motor function; gait function; cyclogram; digital-biomarker

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MDPI and ACS Style

Yoo, J.; Hong, J.; Lee, J.; Cho, Y.; Lee, T.; Rha, D.-w. Assessing Gross Motor and Gait Function Using Hip–Knee Cyclograms in Ambulatory Children with Spastic Cerebral Palsy. Sensors 2025, 25, 4485. https://doi.org/10.3390/s25144485

AMA Style

Yoo J, Hong J, Lee J, Cho Y, Lee T, Rha D-w. Assessing Gross Motor and Gait Function Using Hip–Knee Cyclograms in Ambulatory Children with Spastic Cerebral Palsy. Sensors. 2025; 25(14):4485. https://doi.org/10.3390/s25144485

Chicago/Turabian Style

Yoo, Jehyun, Juntaek Hong, Jeuhee Lee, Yebin Cho, Taekyung Lee, and Dong-wook Rha. 2025. "Assessing Gross Motor and Gait Function Using Hip–Knee Cyclograms in Ambulatory Children with Spastic Cerebral Palsy" Sensors 25, no. 14: 4485. https://doi.org/10.3390/s25144485

APA Style

Yoo, J., Hong, J., Lee, J., Cho, Y., Lee, T., & Rha, D.-w. (2025). Assessing Gross Motor and Gait Function Using Hip–Knee Cyclograms in Ambulatory Children with Spastic Cerebral Palsy. Sensors, 25(14), 4485. https://doi.org/10.3390/s25144485

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