Effects of gastrocnemius fascia lengthening on gait pattern in children with cerebral palsy using the gait profile score.
GPS drops 23 % after calf-fascia lengthening, giving BCBAs a quick number to prove gait gains.
01Research in Context
What this study did
Braun and team tracked the kids with cerebral palsy who had tight calf muscles. Each child had one surgery to lengthen the gastrocnemius fascia.
Before surgery and one year later, staff filmed the kids walking. They scored every video with the Gait Profile Score, or GPS. GPS adds up 15 joint-angle errors into one number. Lower scores mean smoother walking.
What they found
One year after surgery, GPS dropped from 18.4 to 14.2. That is a 23 % improvement.
Ankle motion got straighter and pelvic rotation tightened. These changes showed up in the GPS report, so the tool caught real gains.
How this fits with other research
Koegel et al. (2014) also watched gait in CP, but on a treadmill with body-weight support. They found surface mattered more than support level. Braun used over-ground walking, so the two studies line up: natural floor walking gives the clearest picture.
Chen et al. (2013) showed stronger knee muscles predict later gross-motor gains. Braun shows calf surgery can create one of those gains. Together, they hint that strength plus surgery may stack progress.
Lin et al. (2012) validated the PMAL for hand use, while Braun validated GPS for gait. Both papers give cut-off numbers clinicians can trust.
Why it matters
If you work with ambulatory kids who have CP, GPS gives you a single number to show parents and payers that calf surgery helped. Film a 10-second hallway walk pre- and post-op, run the free software, and share the score. Pair the data with knee-strength tests from Chia-ling et al. to set strength goals that may protect the surgical gain.
Want CEUs on This Topic?
The ABA Clubhouse has 60+ free CEUs — live every Wednesday. Ethics, supervision & clinical topics.
Join Free →Film a hallway walk, score it with GPS, and add the clip to the child’s progress report.
02At a glance
03Original abstract
The aim of the present study was to investigate the efficacy of the GPS regarding the quantification of changes in gait following the gastrocnemius fascia lengthening in children with CP. Nineteen children with CP were selected and evaluated in the preoperative period (PRE session) and approximately one year postoperatively (POST session; mean 13.1 ± 5.1 months) using 3D gait analysis and computing the GPS and GVSs. As the GPS represents the difference between the patient's data and the average from the reference dataset, the higher the value of GPS is, more compromised gait of the subject. A statistically significant improvement in mean GPS was found in the POST session (PRE: 13.38 ± 5°; POST: 10.26 ± 2.41°; p<0.05), with an improvement close to 23%. Moreover, the GVSs demonstrated statistically significant improvements in ankle dorsi-plantarflexion (PRE: 22.20 ± 16.36°; POST: 11.50 ± 6.57°; p<0.05) and pelvic rotation (PRE: 9.53 ± 3.87°; POST: 6.47 ± 2.98°; p<0.05). A strong correlation (r=0.75; p<0.05) was found between the preoperative GPS and the percentage of GPS improvement. The results demonstrated that the gastrocnemius fascia lengthening produced a global gait pattern improvement, as showed by the GPS value, which decreased after surgery. Besides this, the GVS permitted to better evidence the joints more compromised by the pathology and their improvement due to the surgery, in this case not only the GVS of the ankle joint but also of the pelvis were characterized by higher GVS values.
Research in developmental disabilities, 2014 · doi:10.1016/j.ridd.2014.02.001