Clinical decisions on interventions to improve function in children with cerebral palsy (CP) are based, in part, on hypothesized interactions amongst physical signs of CP and functional deficits. However, a knowledge gap exists regarding associations between spasticity and gait function. This study quantified associations of hamstring and triceps surae spasticity with hip, knee and ankle CP gait patterns. This is a cohort study of children and adolescents [n = 51; 31 male; 20 female; spastic diplegia; Gross Motor Function Classification System I (n = 23) and II (n = 28)] who participated in a clinical consult including gait (Motion Analysis, USA) and modified Tardieu scale (MTS) testing (hamstrings, triceps surae). Shape-based clustering was performed on stance phase sagittal hip, knee and ankle patterns using z-normalized and non-normalized data. Linear regression (R, v3.5.0, R Core Team, Austria) was conducted to assess associations between MTS measures and data clusters (α = 0.05). Shape-clustering revealed two hip and three knee and ankle clusters for z-normalized and non-normalized data. Significant associations of hamstring spasticity and joint patterns were observed for z-normalized knee clusters (C_{Knee A} p = 0.002; C_{Knee B} p = 0.006) and interactions amongst non-normalized hip and knee clusters (C_Hip A:C_{Knee B} p = 0.033). Trends were observed for soleus spasticity and gastrocnemius range of motion angle and non-normalized ankle clusters (C_{Ankle B} p = 0.051; C_{Ankle B} p = 0.053 respectively). Significant associations of early knee extension and hamstring spasticity, observed using shape-clustering of z-normalized data, provide unique information that may inform the identification of individuals most likely to benefit from spasticity management and targets for spasticity management assessment.

关于改善脑瘫（CP）儿童功能的干预措施的临床决策部分基于CP体征与功能缺陷之间的假设相互作用。但是，关于痉挛和步态功能之间的关联存在知识差距。这项研究量化了绳肌和肱三头肌肱三头肌痉挛与髋部，膝盖和踝部CP步态模式的关联。这是一项针对儿童和青少年的队列研究[n = 51; 31男；20女；痉挛性截瘫 大运动功能分类系统I（n = 23）和II（n = 28）]参加了包括步态（美国运动分析）和改良的Tardieu量表（MTS）测试（ham绳肌，肱三头肌）的临床咨询。使用z归一化和非归一化数据对姿势相矢状髋，膝和踝模式进行基于形状的聚类。进行了线性回归（R，v3.5.0，R Core Team，奥地利）以评估MTS度量与数据集之间的关联（α= 0.05）。形状聚类显示了用于z归一化和非归一化数据的两个臀部以及三个膝盖和脚踝簇。Z标准化膝关节簇观察到s绳肌痉挛和关节模式的显着关联（C_膝盖A p = 0.002; C_膝B p = 0.006）以及非标准化髋和膝骨簇之间的相互作用（C_髋A：C_膝B p = 0.033）。观察到比目鱼肌痉挛和腓肠肌运动角度范围以及非标准化踝关节簇的趋势（分别为C_踝关节B p = 0.051； C_踝关节B p = 0.053）。使用z归一化数据的形状聚类观察到的早期膝关节伸展和绳肌痉挛的重要关联提供了独特的信息，这些信息可能会有助于识别最有可能受益于痉挛管理的个体以及进行痉挛管理评估的目标。