April 2025 Pediatric Lecture Series: Pediatric Gait Analysis (Part 2 of 3)-Session Recording

Video Transcription

Video Summary

In this second lecture of the Pediatric Rehabilitation series, Dr. Carollo continues exploring gait analysis based on Perry's three critical gait tasks: weight acceptance, single limb support, and swing limb advancement. The prior session covered weight acceptance phases—initial contact and loading response—including control of ankle plantar flexion and hip stability. Today’s focus is single limb support and swing limb advancement.<br /><br />During single limb support, key critical events include controlled tibial advancement (the “ankle rocker”) in mid-stance and controlled ankle dorsiflexion plus the trailing limb posture during terminal stance. A common gait abnormality here, especially in children with cerebral palsy (CP), is crouch gait, characterized by excessive knee and hip flexion and dorsiflexion due to poor tibial control. Severe crouch gait often necessitates surgical intervention such as distal femoral extension osteotomy, which improves knee extension and gait pattern but may still leave compensatory pelvic movements.<br /><br />Swing limb advancement includes pre-swing, initial swing, mid-swing, and terminal swing phases with critical events like passive knee flexion to 40°, knee flexion to 60-70°, hip flexion to 30°, neutral ankle position, and knee extension to neutral to prepare for stance. Abnormalities such as stiff knee gait and foot drop disrupt these events, causing compensations like circumduction and hip hiking. Rectus femoris transfer can address stiff knee gait by improving knee flexion. Foot drop is frequently managed effectively with ankle-foot orthoses or peroneal nerve stimulators.<br /><br />Instrumented gait analysis plays a vital role in assessing gait kinematics, muscle activity, and temporal-spatial parameters, quantifying improvements post-intervention, and distinguishing subtle gait deviations and compensations that guide personalized treatment plans, including surgical and therapeutic options. The lecture concludes underscoring the importance of ongoing gait analysis and multidisciplinary management for optimizing outcomes in pediatric gait abnormalities.

Keywords

Pediatric Rehabilitation

Gait Analysis

Perry's Gait Tasks

Single Limb Support

Swing Limb Advancement

Crouch Gait

Cerebral Palsy

Surgical Intervention

Stiff Knee Gait

Instrumented Gait Analysis