Kinematic foot types in youth with equinovarus secondary to hemiplegia. Gait Posture 2015 Feb;41(2):402-8
Date
12/04/2014Pubmed ID
25467429Pubmed Central ID
PMC4574499DOI
10.1016/j.gaitpost.2014.10.027Scopus ID
2-s2.0-84933523784 (requires institutional sign-in at Scopus site) 31 CitationsAbstract
BACKGROUND: Elevated kinematic variability of the foot and ankle segments exists during gait among individuals with equinovarus secondary to hemiplegic cerebral palsy (CP). Clinicians have previously addressed such variability by developing classification schemes to identify subgroups of individuals based on their kinematics.
OBJECTIVE: To identify kinematic subgroups among youth with equinovarus secondary to CP using 3-dimensional multi-segment foot and ankle kinematics during locomotion as inputs for principal component analysis (PCA), and K-means cluster analysis.
METHODS: In a single assessment session, multi-segment foot and ankle kinematics using the Milwaukee Foot Model (MFM) were collected in 24 children/adolescents with equinovarus and 20 typically developing children/adolescents.
RESULTS: PCA was used as a data reduction technique on 40 variables. K-means cluster analysis was performed on the first six principal components (PCs) which accounted for 92% of the variance of the dataset. The PCs described the location and plane of involvement in the foot and ankle. Five distinct kinematic subgroups were identified using K-means clustering. Participants with equinovarus presented with variable involvement ranging from primary hindfoot or forefoot deviations to deformtiy that included both segments in multiple planes.
CONCLUSION: This study provides further evidence of the variability in foot characteristics associated with equinovarus secondary to hemiplegic CP. These findings would not have been detected using a single segment foot model. The identification of multiple kinematic subgroups with unique foot and ankle characteristics has the potential to improve treatment since similar patients within a subgroup are likely to benefit from the same intervention(s).
Author List
Krzak JJ, Corcos DM, Damiano DL, Graf A, Hedeker D, Smith PA, Harris GFAuthor
Gerald Harris PhD Director in the Orthopaedic Research Engineering Center (OREC) department at Marquette UniversityMESH terms used to index this publication - Major topics in bold
AnkleBiomechanical Phenomena
Case-Control Studies
Cerebral Palsy
Child
Cluster Analysis
Equinus Deformity
Female
Foot
Hemiplegia
Humans
Male
Principal Component Analysis
