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Children
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Clinical Gait Analysis in Children: Progress and Relevance
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Clinical Gait Analysis in Children: Progress and Relevance

A special issue of Children (ISSN 2227-9067). This special issue belongs to the section "Pediatric Neurology & Neurodevelopmental Disorders".

Deadline for manuscript submissions: closed (1 November 2024) | Viewed by 10028

Special Issue Editors

Dr. Matthias Hösl

E-Mail Website
Guest Editor
Schön Klinik Vogtareuth, Gait and Motion Analysis Laboratory, Vogtareuth, Germany
Interests: (neuro)orthopedics; neurology; rehabilitation; sports and podiatry with an emphasis on children
Dr. Nathalie Alexander

E-Mail Website
Guest Editor
Children's Hospital of Eastern Switzerland, St Gallen, Switzerland
Interests: gait analysis; biomechanics; posture; motion analysis

Special Issue Information

Dear Colleagues,

Often taken for granted, skills such as walking, running or other locomotor modes are deemed vital aspects of mobility in children. Quantitative motion analysis facilitates the identification of atypical characteristics, helps observing and evaluating them and assists in identifying the source of impairments. This special issue focuses on the application of clinical human movement science with an emphasis on biomechanics of locomotion. Special attention will be put on the value of motion capturing in the context of medical and clinical treatments with various tools, devices and technologies. Main focus will be put on 3 key topics:

  • Better detect pathologies and understand their genesis.
  • Optimize diagnostics and clinical decisions making.
  • Enhance interventions, such as exercises, therapy, orthoses, walking aids, drugs or invasive treatments to alleviate impairments and lower the burden for children.

The spectrum of cohorts may be multifaceted. Methodological work that demonstrates and optimizes the applicability, accuracy and validity of motion capture technology in the medical context is welcome, too.

While the scope of this special issue is to be diverse, it is mandatory that each publication comments in detail on the added value and benefit of the findings from the perspective of practitioners, caregivers, families and foremost of the pediatric patients' point of view.

Dr. Matthias Hösl
Dr. Nathalie Alexander
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Children is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2400 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • gait
  • gait analysis
  • biomechanics
  • motion analysis
  • movement analysis
  • motion capture
  • 3D motion analysis
  • kinematics
  • electromyography
  • rehabilitation
  • orthotics
  • musculoskeletal abnormalities
  • rehabilitation
  • movement disorders
  • neuropediatrics
  • neurology
  • pediatric orthopedics

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Published Papers (6 papers)

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Research

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16 pages, 3403 KiB  
Article
Frontal Plane Knee Kinematics and Kinetics During Gait in Children and Youth with Achondroplasia—Correspondence with Static X-Ray Images and Relevance to Symptoms
by Matthias Hösl, Antonia Thamm, Faik Kamel Afifi and Sean Nader
Children 2025, 12(1), 78; https://doi.org/10.3390/children12010078 - 10 Jan 2025
Viewed by 620
Abstract
Background: Frontal knee malalignments are hallmarks of Achondroplasia (ACH), along with disproportional short stature. Typically, X-rays are used to assess them, but 3D gait analysis (3DGA) may additionally be used to evaluate dynamic knee function. The research questions were as follows: (1) [...] Read more.
Background: Frontal knee malalignments are hallmarks of Achondroplasia (ACH), along with disproportional short stature. Typically, X-rays are used to assess them, but 3D gait analysis (3DGA) may additionally be used to evaluate dynamic knee function. The research questions were as follows: (1) What is the relationship between X-rays and 3DGA in ACH? (2) Do children with ACH have abnormal frontal knee kinematics and kinetics? (3) Are there aspects of 3DGA that relate to knee symptoms? Methods: A total of 62 knees of 31 children with ACH (age: 11.1 ± 4.3 years, 34 symptomatic knees) underwent 3DGA and X-ray as part of their standard clinical care. X-rays were analyzed for mechanical tibiofemoral angle (mTFA). Relationships between X-rays and 3DGA were determined. Sixty-two knees of 31 age-matched typically developing (TD) children served as references for 3DGA. Frontal knee kinematics (including thrust RoM) and adduction moments (KAMs) were compared. Multiple regression was performed for measurements associated with KAM, and ANOVA was used to compare TD and ACH knees with and without pain. Results: There was a high correlation between static frontal knee angles and mTFA (r = 0.93, p < 0.001, mean difference = −2.9°). ACH knees with a regular mTFA also showed significantly increased KAM. Multiple regression analysis showed that mTFA was the most relevant predictor of KAM (R2 = 0.41–0.75). Symptomatic knees (n = 34/62) experienced significantly more knee RoM in early stance than asymptomatic knees. Conclusions: Three-dimensional gait analysis may be an objective screening method for dynamic knee alignment and stability and may complement radiography in monitoring ACH. Symptoms may depend on knee thrust, while the impact of altered KAM needs further study. Full article
(This article belongs to the Special Issue Clinical Gait Analysis in Children: Progress and Relevance)
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10 pages, 592 KiB  
Article
The Ponseti Method vs. Surgical Treatment for Idiopathic Clubfoot: A Prospective Long-Term Follow-Up
by Martin Svehlik, Bernhard Guggenberger, Michael Stöckler, Sebastian Klim and Tanja Kraus
Children 2024, 11(12), 1422; https://doi.org/10.3390/children11121422 - 26 Nov 2024
Viewed by 819
Abstract
Background: Idiopathic clubfoot is a common skeletal deformity in newborns that can cause functional limitations, pain, and reduced quality of life. The Ponseti method has become the gold standard for clubfoot treatment, replacing previous extensive surgical approaches. However, there is a lack of [...] Read more.
Background: Idiopathic clubfoot is a common skeletal deformity in newborns that can cause functional limitations, pain, and reduced quality of life. The Ponseti method has become the gold standard for clubfoot treatment, replacing previous extensive surgical approaches. However, there is a lack of prospective long-term data comparing surgical and Ponseti treatments. Methods: This is a follow-up on a single-center, prospective, randomized clinical trial that started in 2001. The aim of this study was to compare the Ponseti method with surgical treatment. The current report presents the long-term results at adulthood of 12 clubfeet (9 subjects) in the Ponseti group and 9 clubfeet (5 subjects) in the surgical group. The evaluation included morphology, function, and quality of life, which were assessed through gait analysis, X-rays, and standardized questionnaires (FRS, ICFSG, AOFAS, SF-36). A Functional Rating System for clubfeet was defined as the primary outcome. Results: The Ponseti group had higher Functional Rating System scores, better ankle dorsiflexion mobility, and lower pain levels. Additionally, they reported better quality of life according to the Short Form 36 survey. However, neither group achieved radiographically normal foot morphology. Conclusions: The 18-year follow-up results indicate that the Ponseti method produces superior outcomes in terms of mobility, gait, function, and quality of life when compared to surgically treated feet, despite the presence of persistent morphological deviations. Full article
(This article belongs to the Special Issue Clinical Gait Analysis in Children: Progress and Relevance)
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13 pages, 693 KiB  
Article
Walking and Running of Children with Decreased Femoral Torsion
by Christos Tsagkaris, Marry E. Hamberg, Christina Villefort, Thomas Dreher and Britta K. Krautwurst
Children 2024, 11(6), 617; https://doi.org/10.3390/children11060617 - 22 May 2024
Viewed by 1417
Abstract
Understanding the implications of decreased femoral torsion on gait and running in children and adolescents might help orthopedic surgeons optimize treatment decisions. To date, there is limited evidence regarding the kinematic gait deviations between children with decreased femoral torsion and typically developing children, [...] Read more.
Understanding the implications of decreased femoral torsion on gait and running in children and adolescents might help orthopedic surgeons optimize treatment decisions. To date, there is limited evidence regarding the kinematic gait deviations between children with decreased femoral torsion and typically developing children, as well as the implications of the same on the adaptation of walking to running. A three-dimensional gait analysis study was undertaken to compare gait deviations during running and walking among patients with decreased femoral torsion (n = 15) and typically developing children (n = 11). Linear mixed models were utilized to establish comparisons within and between the two groups and investigate the relationship between clinical examination, spatial parameters, and the difference in hip rotation between running and walking. Patients exhibited increased external hip rotation during walking in comparison to controls, accompanied by higher peaks for the same as well as for knee valgus and external foot progression angle. A similar kinematic gait pattern was observed during running, with significant differences noted in peak knee valgus. In terms of variations from running to walking, patients internally rotated their initially externally rotated hip by 4°, whereas controls maintained the same internal hip rotation. Patients and controls displayed comparable kinematic gait deviations during running compared to walking. The passive hip range of motion, torsions, and velocity did not notably influence the variation in mean hip rotation from running to walking. This study underlines the potential of 3D gait kinematics to elucidate the functional implications of decreased FT and, hence, may contribute to clinical decision making. Full article
(This article belongs to the Special Issue Clinical Gait Analysis in Children: Progress and Relevance)
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18 pages, 4213 KiB  
Article
A Comparison of the Immediate Effects of Verbal and Virtual Reality Feedback on Gait in Children with Cerebral Palsy
by Tine De Mulder, Heleen Adams, Tijl Dewit, Guy Molenaers, Anja Van Campenhout and Kaat Desloovere
Children 2024, 11(5), 524; https://doi.org/10.3390/children11050524 - 27 Apr 2024
Viewed by 1478
Abstract
Different types of feedback are used during gait training in children with cerebral palsy (CP), including verbal (VB) and virtual reality (VR) feedback. Previous studies on VR feedback showed positive effects on the targeted gait parameter. However, both positive and negative side effects [...] Read more.
Different types of feedback are used during gait training in children with cerebral palsy (CP), including verbal (VB) and virtual reality (VR) feedback. Previous studies on VR feedback showed positive effects on the targeted gait parameter. However, both positive and negative side effects on other parameters were seen as well. The literature on the effect of VB feedback is lacking and, to our knowledge, both feedback methods have not yet been compared. In this monocentric study with a single-session intervention protocol, children with CP completed a training session on the Gait Real-Time Analysis Interactive Lab (GRAIL) and received both VB and VR feedback on hip extension, in randomized order. Outcome parameters were continuous gait curves of sagittal kinematics and hip kinetics, specific features of hip angle and moment, sagittal gait variable scores and gait profile scores. Improvement of the targeted gait parameter was seen both after VB and VR feedback, with a small advantage for VR over VB feedback. Furthermore, positive side effects on knee and ankle sagittal kinematics were seen. However, the overall gait profile score did not improve, most likely due to negative compensatory strategies. In conclusion, children with CP can adapt gait in response to both VB and VR feedback, with VR feedback producing a slightly better effect. Due to secondary effects on parameters other than the targeted parameter, the overall gait did not improve. Full article
(This article belongs to the Special Issue Clinical Gait Analysis in Children: Progress and Relevance)
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18 pages, 1634 KiB  
Systematic Review
Dynamic Gait Analysis in Paediatric Flatfeet: Unveiling Biomechanical Insights for Diagnosis and Treatment
by Harald Böhm, Julie Stebbins, Alpesh Kothari and Chakravarthy Ughandar Dussa
Children 2024, 11(5), 604; https://doi.org/10.3390/children11050604 - 17 May 2024
Cited by 1 | Viewed by 2447
Abstract
Background: Flatfeet in children are common, causing concern for parents due to potential symptoms. Technological advances, like 3D foot kinematic analysis, have revolutionized assessment. This review examined 3D assessments in paediatric idiopathic flexible flat feet (FFF). Methods: Searches focused on paediatric idiopathic FFF [...] Read more.
Background: Flatfeet in children are common, causing concern for parents due to potential symptoms. Technological advances, like 3D foot kinematic analysis, have revolutionized assessment. This review examined 3D assessments in paediatric idiopathic flexible flat feet (FFF). Methods: Searches focused on paediatric idiopathic FFF in PubMed, Web of Science, and SCOPUS. Inclusion criteria required 3D kinematic and/or kinetic analysis during posture or locomotion, excluding non-idiopathic cases, adult feet, and studies solely on pedobarography or radiographs. Results: Twenty-four studies met the criteria. Kinematic and kinetic differences between FFF and typical feet during gait were outlined, with frontal plane deviations like hindfoot eversion and forefoot supination, alongside decreased second peak vertical GRF. Dynamic foot classification surpassed static assessments, revealing varied movement patterns within FFF. Associations between gait characteristics and clinical measures like pain symptoms and quality of life were explored. Interventions varied, with orthoses reducing ankle eversion and knee and hip abductor moments during gait, while arthroereisis normalized calcaneal alignment and hindfoot eversion. Conclusions: This review synthesises research on 3D kinematics and kinetics in paediatric idiopathic FFF, offering insights for intervention strategies and further research. Full article
(This article belongs to the Special Issue Clinical Gait Analysis in Children: Progress and Relevance)
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21 pages, 2479 KiB  
Systematic Review
Bone Deformities through the Prism of the International Classification of Functioning, Disability and Health in Ambulant Children with Cerebral Palsy: A Systematic Review
by Rodolphe Bailly, Christelle Pons, Anne-Charlotte Haes, Lisa Nguyen, Matthias Thepaut, Laëtitia Houx, Mathieu Lempereur and Sylvain Brochard
Children 2024, 11(2), 257; https://doi.org/10.3390/children11020257 - 16 Feb 2024
Cited by 1 | Viewed by 1850
Abstract
(1) Aim: The aim of this study was to determine the relationship between lower limb bone deformities and body functions, activity, and participation in ambulant children with CP and whether changing bone morphology affects outcomes in these domains. (2) Methods: A systematic literature [...] Read more.
(1) Aim: The aim of this study was to determine the relationship between lower limb bone deformities and body functions, activity, and participation in ambulant children with CP and whether changing bone morphology affects outcomes in these domains. (2) Methods: A systematic literature search (PROSPERO CRD42020208416) of studies reporting correlations between measures of lower limb bone deformities and measures of body function, activity or participation, or post-surgical outcomes in these domains was conducted from 1990 to 2023 in Medline, Scopus, and Cochrane Library. We assessed study quality with the Checklist for Case Series (CCS) and a quality assessment developed by Quebec University Hospital. Meta-analysis was not possible; therefore, descriptive synthesis was performed. (3) Results: A total of 12 of 3373 screened articles were included. No studies evaluated the relationships between bone deformities and activity or participation, or the effect of isolated bone surgery on these domains. Correlations between bone deformities and body functions were poor-to-moderate. Internal hip rotation during gait improved after femoral derotation osteotomy. (4) Conclusions: A shift in paradigm is urgently required for the research and management of bone deformities in children with CP to include the activity and participation domains of the ICF, as well as consider more psychological aspects such as self-image. Full article
(This article belongs to the Special Issue Clinical Gait Analysis in Children: Progress and Relevance)
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