Patients with cerebral palsy may have improved gait after surgery regardless of age
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Key takeaways:
- Gait deviation index increased by 6.1 in patients younger than 13 years and by 6.4 in patients aged 13 years or older.
- Younger patients had decreased nondimensional walking speed and stride length after surgery.
Results showed patients with cerebral palsy who underwent a single event multilevel surgery had improved gait deviations regardless of age.
“If you have a child who is having walking difficulties and you have a well-thought-out surgical plan, you can help them significantly,” Robert M. Kay, MD, director of the Jackie and Gene Autry Orthopedic Center at Children’s Hospital Los Angeles, told Healio.
Kay and colleagues retrospectively reviewed data from 126 patients with cerebral palsy who underwent two gait analysis tests and intervening lower extremity orthopedic surgery between 2011 and 2023. Researchers evaluated preoperative to postoperative changes in walking speed, stride length and gait deviation index for patients younger than 13 years and those aged 13 years or older. Researchers also combined functional mobility scale scores 3 and 4 and wheelchair/crawling for analysis and compared improvement or worsening between age groups.
“The main findings are that in children who are younger than 13 years old and those who are older than 13 years old, we see a significant improvement in walking scores,” Kay said about results presented at the Gait & Clinical Movement Analysis Society Annual Meeting.
Results showed gait deviation index scores increased by 6.1 in patients younger than 13 years and by 6.4 in patients aged 13 years and older, with no significant difference between the two groups.
“Typically when we look at normal gait, we would get a score of 100 and every 10 points away from 100 is one standard deviation below,” Kay said. “A change of four is clinically significant, and we had changes of over six in both groups.”
Researchers found patients younger than 13 years had a statistically significant decrease in nondimensional walking speed and stride length after surgery. Investigators found patients younger than 13 years also had a significant improvement on the functional mobility scale for walking ability at the 500-meter distance, but there were no such findings for any other distance or age group.
“These results will impact the future of orthopedics by making people realize that you can help children who are in adolescence who are having deterioration of their walking abilities and walking patterns,” Kay said. “You do not have to attribute a deterioration to the natural history of the process and be fearful that you cannot have anything to offer them to improve their function and quality of life.”
Robert M. Kay, MD, of Children’s Hospital Los Angeles, can be reached at lasong@chla.usc.edu.
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Hanson A, et al. Impact of age on gait deviations after orthopedic intervention in children with cerebral palsy. Presented at: Gait & Clinical Movement Analysis Society Annual Meeting; June 16-18, 2024; Atlanta.
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