Extract
In the last fifteen years, a new paradigm has emerged for orthopaedic
clinical decision-making to optimize the walking ability of children with
cerebral palsy. This paradigm is based on the biomechanics of normal gait,
pathologic gait, and gait disruptions associated with distinct clinical
disease processes as well as on a greater understanding of the anatomy and
physiology of the muscle-tendon unit and the importance of skeletal
alignment1.Normal gait has been studied, and with current technology we are now able
to quantitatively measure the normal movements associated with gait
(kinematics) and to objectively assess the principal applied moments acting
about the joints (kinetics) during the gait
cycle1,2.
This information, coupled with the electrical potentials generated by
individual muscles during the gait cycle (dynamic electromyography), has
documented the maturation of normal gait in children and led to the
development of agematched normal profiles for
walking3.