1st Joint ESMAC-GCMAS Meeting - Análise de Marcha

flexion greater than norms in terminal swing but close to norms in terminal stance. Ankle
patterns in all groups lack 1 st rocker, have early dorsiflexion following initial contact and have
slight dropfoot in terminal swing.
Group A Group B Group C Group D
Figure 1. Sagittal plane kinematic pattern ensemble averages ± 1s.d. for groups A-D with
normal data ± 1 s.d. plotted for comparison.
Discussion
The exaggerated pelvic tilt pattern of group A may reflect the increased trunk movement
observed frequently in patients with HSP. While the triple-bump knee pattern is not
immediately apparent with observational assessment, trunk movement frequently is obvious.
The incorporation of upper extremity data would provide insight into the role of the trunk and
arms during gait in children with HSP. Group B has a young mean age (5.4 ± 2.2yrs) possibly
reflecting a lower level of spasticity or contracture development. Group C has similarities to
the crouch gait pattern of spastic diplegia in the flexed hip and knee position, but lacks both the
posterior pelvic tilt and ankle hyperdorsiflexion typically seen in true crouch gait. It is noted
that group D includes three of the four patients without family history of HSP. Further analysis
with additional patients will further substantiate these patterns.
References
[1] Fink JK, (2003), Arch of Neurol, 60:1045-1049.
[2] Klebe S et al, (2004), J of Neurol, 251:571-578.
[3] Rodda JM et al, (2004), JBJS (Br), 86-B (2):251-258.
Acknowledgements
The authors would like to thank Dr. Michael Sussman, Dr. Jonathan Sembrano, Rosemary Pierce, PT, Rita Davis,
PT and Susan Sienko Thomas, MA for their assistance.
- 141 -