MULTIFACTORIAL GAIT ANALYSIS IN THE PHYSICAL AND REHABILITATION MEDICINE OF THE GAIT DISORDERS IN CHILDREN

SCOPE. BACKGROUND: The Multifactorial Motion Analysis is instrumental method of evaluation of the body’s motion on the basis of a biomechanical model. It quantifies the lower limb’ segmental motion during walking and it has major benefits and application in clinical problems.MATERIAL& METHODS: 147 patients with age between 2 and 26 years and with different gait problems were evaluated in our Gait Lab from February 2015 to March 2016. The integrated system provides information about the spatial and temporal parameters of the gait, the 3D kinematics (lower limb joints’ angle variation during gait cycle), the kinetics (ground reaction forces, joints’ moments and powers) and the dynamic surface EMG (muscular activation).RESULTS: Among the 147 patients, 60.5% were children with cerebral palsy, 17.6% children with gait problems of orthopedic origin, 8.1% peripheral neuropathies and muscular diseases, 5.4% post-trauma neurological status (brain or medullar injuries), 1.3% malformative congenital syndromes.  All these data provided by the gait analysis, considered into a clinical examination, helped us to understand and quantify the gait disorders, to identify the role of each pathological element in producing the gait anomalies and to ensure a correct management of the therapeutic recommendations : better defining the targets in physical rehabilitation process,  indicating and adapting the most suitable walking orthotics (55.1% patients), choosing the targeted muscles for the botulinum toxin injection protocol  in order to improve function (65.3%), directing the most suitable type of orthopedic interventions (22.4%). It also an objective evaluation tool for the therapeutic benefits and for following up the evolution of gait problems in children during growth period.CONCLUSIONS: The Multifactorial Gait Analysis is a very important and accurate method of evaluation of gait disorders, with a major role in the therapeutic approach of neurological and orthopedic pathology in children.