Background

Crouch or flexed-knee gait is one of the most common pathological gait patterns in cerebral palsy (CP). Differences exist in definitions used; the degree of knee flexion, inclusion of hip or ankle position, and timing in the gait cycle. This ambiguity may be responsible for variations in prevalence rates and difficulty comparing data across studies.

Research question

What are the kinematic parameters used to define crouch or flexed-knee gait in CP gait? A secondary aim was to examine the quality of data reporting, focusing on the sample characteristics, inclusion/exclusion criteria and the choice of limb included for analysis.

Methods

Articles included in this review reported on a specified cohort of adults or children with crouch or flexed-knee gait assessed with 3-dimensional gait analysis. A customised data extraction and quality assessment table was designed specific to the research question.

Results

The majority (75 %) of included studies used the term crouch gait. Where the pattern was defined, 80 % of crouch papers and 94 % of flexed-knee gait papers based this solely on knee position. Kinematic parameters were clearly defined when they provided objective values of knee flexion, supported this with rationale and provided a reference point in the gait cycle. Only 22 % of crouch papers and 19 % of flexed-knee gait papers provided this information. The majority of studies (67 % crouch; 90 % flexed-knee) specified which limb(s) were included for analysis with the majority including both limbs. Objective values of knee flexion ranged from 8 o to 30 o.

Significance

This review highlights that crouch and flexed knee are synonymous and ambiguity exists in the kinematic definition making it difficult to make compare data amongst study cohorts. Future research should provide detailed definitions including the threshold value of knee flexion, how it was derived, the timing in the gait cycle and the limb(s) included in analysis.

中文翻译：

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下肢瘫痪或屈膝步态：有区别吗？系统的审查。

背景

蹲伏或屈膝步态是脑性瘫痪（CP）中最常见的病理步态模式之一。使用的定义存在差异。膝盖屈曲程度，髋部或踝部位置以及步态周期的时机。这种歧义可能是导致患病率变化和难以比较各个研究数据的原因。

研究问题

在CP步态中用于定义蹲伏或屈膝步态的运动学参数是什么？第二个目的是检查数据报告的质量，重点是样本特征，纳入/排除标准以及要分析的肢体的选择。

方法

这篇综述中的文章报道了特定人群的成年人或儿童的蹲伏或屈膝步态，并通过3维步态分析进行了评估。针对研究问题设计了定制的数据提取和质量评估表。

结果

纳入研究的大多数（75％）使用了“蹲伏步态”一词。在定义图案的地方，80％的蹲伏纸和94％的屈膝步态纸仅基于膝盖位置。运动参数在提供膝部屈曲的客观值时提供了明确的定义，并为其提供了理论依据并为步态周期提供了参考点。提供此信息的只有22％的蹲伏纸和19％的屈膝步态纸。大多数研究（67％蹲伏； 90％屈膝）规定了要分析的肢体，而大多数都包括双肢。膝关节屈曲的客观值范围为8 o至30 o。

意义

这篇评论强调了蹲下和屈膝是同义词，并且运动学定义中存在歧义，这使得很难在研究人群之间进行比较数据。未来的研究应提供详细的定义，包括膝盖屈曲的阈值，其得出方式，步态周期的时间以及分析中包括的四肢。