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EUROPEAN JOURNAL OF PHYSICAL AND REHABILITATION MEDICINE
A Journal on Physical Medicine and Rehabilitation after Pathological Events
Official Journal of the , , , ,
In association with
Indexed/Abstracted in: CINAHL, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 2,063
SHORT ORIGINAL ARTICLES
Europa Medicophysica 2002 December;38(4):215-218
Gait patterns after traumatic brain injury
Centro Cardinal Ferrari”, Fontanellato (Parma)
Background. Gait analysis can be used to subdivide a population of patients into different groups, according to the patterns of movement. In this way it can be possible to plan specific therapeutic interventions for each pattern of movement. The classifications of Knuttson, Winter, Muroy and Perry are examined.
Methods. The classification of gait patterns proposed by Knuttson is based on goniometric data for the knee and the ankle and on emg. The classification of Winter is based on goniometric data from the 3 principal joints of the leg. The classification of Mulroy and Perry is based on velocity and goniometric data from the knee at terminal stance phase and at preswing phase. These classifications, originally addressing patients with cerebrovascular disease, are used for a group of 14 subjects with traumatic brain injury.
Results. According to Knuttson’s classification patients are divided as follows: type I (premature activation of calf muscles) no. 7 (50%), type II (marked lowering of emg activity) 0 (0%), type III (co-activation) no. 4 (29%), type IV (more complex types) no. 3 (21%). Therefore with the classification of Knuttson is possible to assign 79% of patients, while 21% of cases are labeled as type IV (more complex types). According to the classification of Winter patients are divided as follows: group I (insufficient ankle control) no. 6 (43%), group II (same problem plus ankle plantar flexion in stance phase) no. 3 (21%), group III (reduction of knee flexion motion in the swing phase due to quadriceps overactivity) no. 1 (7%), group IV (same problem of group III, plus flexed position of the hip with reducted range of motion) no. 2 (14%), plus 2 unclassifiable subjects (14%). According to Mulroy and Perry’s classification patients are divided as follows: group 1 (fast) no. 5 (36%), group 2 (moderate) no. 6 (43%), group 3 (flexed) no. 1 (7%), group 4 (extended) no. 2 (14%).
Conclusions. This study suggests that the gait classifications born for the upper motor neuron lesion due to cerebrovascular disease can be use, yet with some limitations, in subjects with traumatic brain injury. Of the 3 classification examined the classification of Mulroy and Perry seems to fit better with this type of patients as it is possible to assign all patients, although some isolated goniometric values are different from the expected ones.