Gait analysis in children with hemiplegic cerebral palsy: foot-floor contact and EMG activation patterns

INTRODUCTION and AIM In children, hemiplegia is a common consequence of cerebral palsy (CP) and causes altered selective motor control, weakness and spasticity. A correct classification of children with CP is important to assist diagnosis and clinical decision-making. The classification of spastic hemiplegia proposed by Winters et al. is widely accepted in literature. Type I is defined by the presence of drop foot in swing, type II by the persistence of equinism throughout the gait cycle, with a possible knee hyperextension in stance. Foot-contact event detection is fundamental in clinical gait analysis, but it is particularly challenging in children with CP due to initial toecontact. In a recent work, we described an algorithm for the automatic segmentation of gait cycles from the foot-switch signal that it is applicable also to pathological gait. The aim of this contribution is to apply this method to a population of CP children to study their foot-floor contact sequences, considering also the sub-phases of stance. The activation patterns of tibialis anterior (TA) and gastrocnemius lateralis (GL) helped us in the interpretation of the results.