The role of gait analysis in the orthopaedic management of ambulatory cerebral palsy.
OBJECTIVE
The literature was reviewed to describe the role of gait analysis in the orthopaedic management of ambulatory children with cerebral palsy and examine the current best evidence to support these roles.


RESULTS
Gait laboratory analysis is superior to visual or observational analysis of gait because it provides an objective record of gait that is able to quantify the magnitude of deviations of pathologic gait from normal and also explain these abnormalities. Recognizable gait patterns can be classified and used for making treatment decisions, the effectiveness of which can be assessed using gait analysis as a measure of gait outcomes. There are many sources of variability, however, including patients themselves, the gait laboratories and testing processes, interpretation of data and surgeons' surgical recommendations.


CONCLUSIONS
Although gait analysis has been shown to alter decision making, there is little evidence that the decisions based on gait analysis lead to better outcomes. Consequently, clinical gait analysis remains controversial, with wide variation in the rates of utilization of gait analysis in the management of children with ambulatory cerebral palsy. The time is ripe for clinical trials and cohort studies to provide the evidence to establish the appropriate utilization of this technology.
Narayanan
Unni G
UG
Divisions of Orthopaedic Surgery and Population Health Sciences, The Hospital for Sick Children, University of Toronto, Toronto, Canada. unni.narayanan@sickkids.ca
D000556:Ambulatory Surgical Procedures / Q000379:methods*; D002547:Cerebral Palsy / Q000503:physiopathology / Q000601:surgery*; D002648:Child; D003657:Decision Making; D005684:Gait / Q000502:physiology*; D006801:Humans; D019637:Orthopedic Procedures; D013673:Technology Assessment, Biomedical / Q000639:trends