Position Between Trunk and Pelvis During Gait Depending on the Gross Motor Function Classification System.

PURPOSE: To understand whether there is a trunk postural control threshold in the sagittal plane for the transition between the Gross Motor Function Classification System (GMFCS) levels measured with 3-dimensional gait analysis. METHOD: Kinematics from 97 children with spastic bilateral cerebral palsy from spine angles according to Plug-In Gait model (Vicon) were plotted relative to their GMFCS level. RESULTS: Only average and minimum values of the lumbar spine segment correlated with GMFCS levels. Maximal values at loading response correlated independently with age at all functional levels. Average and minimum values were significant when analyzing age in combination with GMFCS level. CONCLUSION: There are specific postural control patterns in the average and minimum values for the position between trunk and pelvis in the sagittal plane during gait, for the transition among GMFCS I-III levels. Higher classifications of gross motor skills correlate with more extended spine angles.

Can Clinical Assessment of Locomotive Body Function Explain Gross Motor Environmental Performance in Cerebral Palsy?

Gross Motor Function Classification System has discriminative purposes but does not assess short-term therapy goals. Locomotion Stages (LS) classify postural body functions and independent activity components. Assessing the relation between Gross Motor Function Classification System level and Locomotion Stages will make us understand if clinical assessment can explain and predict motor environmental performance in cerebral palsy. A total of 462 children were assessed with both scales. High reliability and strong negative correlation (-0.908) for Gross Motor Function Classification System and Locomotion Stages at any age was found. Sensitivity was 83%, and specificity and positive predictive value were 100% within the same age range. Regression analysis showed detailed probabilities for the realization of the Gross Motor Function Classification System depending on the Locomotion Stages and the age group. Postural body function measure with Locomotion Stages is reliable, sensitive, and specific for gross motor function and able to predict environmental performance.