Analysis of gait abnormalities in children with cerebral palsy based on temporal parameters and kinematic angles

Background: Children with cerebral palsy (CP) often present with substantial motor impairments that affect both gait and postural control. A comprehensive multidimensional assessment of abnormal gait patterns is essential to establish a theoretical foundation for individualized rehabilitation strategies. Methods: Fifteen children with spastic hemiplegia (SH), 13 children with spastic diplegia (SD), and 30 typically developing (TD) children participated in an 8-minute upright walking task. Temporal gait parameters and kinematic angle parameters were recorded. Gait symmetry was quantified using the phase symmetry index (ID ps ), F-step size symmetry index (ID sp ), and asymmetry index (ASI). Gait variability was evaluated through sample entropy (SampEn), gait variability index (GVI), and gait deviation index (GDI). In addition, continuous relative phase (CRP) analysis was used to quantify the inter-joint coordination of ankle-knee, ankle-hip, and knee-hip joint pairs. Statistical analysis was performed using 1-way analysis of variance (ANOVA). Results: The TD group demonstrated significantly superior gait symmetry compared with both the SD and SH groups. The bilateral GDI index in TD group was significantly greater than that in SD and SH groups. Significant differences in SampEn for temporal parameters and kinematic angle were primarily observed between TD group and SD group. Except the SampEn for the left foot roll angle and ankle joint, all other statistically significant SampEn for metrics showed higher values in the children with cerebral palsy (CP) than in TD group; the mean absolute relative phase (MARP) value of the left ankle-knee joint pair in SD group showed a significant decrease during the initial swing phase (ISw). Conclusions: The results indicated that children with CP exhibited more complex temporal structures and kinematic variations in gait cycle. The foot-ankle showed a more rigid gait pattern, with discrepancies in ankle-knee coordination, suggesting the critical role of the foot-ankle in walking. These findings can assist clinicians in assessing children’s motor control capabilities and compensatory strategies, providing quantitative evidence for establishing individualized training objectives.