0000004411 00000 n We found between-pattern differences in synergy weights of all eight muscles for all synergies (analysis of covariance). The sagittal plane motions of the pelvis, hip, knee, and ankle joints were compared to those of a typically developing sample of 57 children (mean age: 11y 4mo, SD: 4y 3mo, range: 4y 7mo–17y 1mo; 32 females). Ph.D. The authors declare that the research was conducted without any commercial or financial relationships. Greater impairment relates to more changes in synergy weights in CP. REF, rectus femoris; VAL, vastus lateralis; BIF, biceps femoris; MEH, medial hamstrings; TIA, tibialis anterior; GAS, gastrocnemius; SOL, soleus; GLU, gluteus medius. Apparent equinus - knee flexion with neutral ankle c. Calcaneal crouch - excessive knee flexion and excessive ankle dorsiflexion II. The current study aimed to investigate influences of rigid Ankle Foot Orthoses (AFOs) on gait in children with Cerebral Palsy (CP), immediate effects of tuning of AFO-FC (AFO-Footwear Combination) on gait of children with CP, short-term ... unilateral vs bilateral).5. LESSER GLUTEAL MUSCLES AND TRENDELENBURG GAIT:Trendelenburg gait results from the loss of function of lesser gluteal muscles. 1. Forces at each level each plane affect other levels and planes a. E.g. Gait Abnormalities | Stanford Medicine 25 | Stanford Medicine The Biomechanical Optimisation (tuning) of the Ankle Foot ... 0000007358 00000 n Synergy activations and weights per gait pattern. 0000004595 00000 n 0000005565 00000 n 0000005408 00000 n 0000052227 00000 n 0000008570 00000 n reported significant differences in synergy activations between different GMFCS levels in CP, but not in synergy weights.6 Additionally, Steele et al. Found inside – Page 302In jump gait pattern, full knee extension in midstance may occur. This is not a contraindication to lengthening of the medial hamstrings. □ In crouch gait pattern, increased knee flexion will be of greater magnitude and is present ... Joint aspiration can be the most important test for septic arthritis. Literature suggests that instrumented gait analysis is a valuable tool in . The concatenated signal was normalized to its average amplitude. Sylvia Õunpuu. [1] Sutherland and Davids described four pathological gait patterns in spastic diplegia based on knee motion in the sagittal plane (Jump, crouch, equinus, and stiff-knee gait). Therefore, we first ran a non-parametric one-way analysis of variance (SnPM[F]). Brain lesion location and severity, in combination with the neural capacity of the CNS to compensate for this brain lesion, are expected to dictate this strategy. A 10 to 15 camera Vicon system (Vicon-UK, Oxford, UK) and two force plates (AMTI, Watertown, MA, USA) collected marker trajectories and ground reaction forces. How these motor control strategies interact with musculoskeletal impairments and relate to gait kinematics still needs to be determined. In case of a significant outcome, we used a post hoc non-parametric two-tailed, two-sample t-test (SnPM[t]) to assess potential differences in synergy activations between the gait patterns. We collected sEMG data from the rectus femoris, vastus lateralis, biceps femoris, medial hamstrings, tibialis anterior, medial gastrocnemius, soleus, and the gluteus medius, with a 16-channel wireless sEMG system (Zerowire, Cometa, Italy) at 1000Hz or 1500Hz. This book reviews in detail the history of motion analysis, including the earliest attempts to capture, freeze, study and reproduce motion. This third edition systematically reviews recent developments in the diagnosis and evidence-based treatment of cerebral palsy, a consequence of foetal and early infant brain damage resulting in lifelong disabilities with a range of clinical ... Although there were differences in synergy weights, these were not clearly related to the gait pattern or walking speed. Within the CP population, multiple types of pathological gait patterns are present such as True equinus, Jump knee, Apparent equinus, and Crouch gait (Rodda and Graham, 2001). 0000014397 00000 n R26.0 Ataxic gait. The results are briefly depicted trough Figures 1 and 2. 9/26/2019 4 •Definition •Etiology •Classification •Hip (Neuromuscular Dysplasia) •Gait (Patterns / Orthotics) •Single Event Multilevel Surgery (SEMLS) •Spine •Tone Management CEREBRAL PALSY •ETIOLOGY •PREINATAL •Insult To Normal CNS •Infection, Ischemia, Contusion •Abnormal CNS Structure •Neuronal Migration Disorders • PERINATAL • Birth anoxia, neonatal sepsis, BPD, Descriptive statistics were used for differences in tVAF1 and walking speed. 23 GaitAbnormalitiesinCP 24. The Handbook of Human Motion is a large cross-disciplinary reference work which covers the many interlinked facets of the science and technology of human motion and its measurement. An antalgic gait is a gait that develops as a way to avoid pain while walking (antalgic = anti- + alge, "against pain"). <>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> An addi-tional pattern of 'minor deviations' was added, which. The sagittal gait patterns of true equi-nus, jump gait, and apparent equinus4 were not seen in this cohort. 2. 1. 0000003760 00000 n We selected four representative gait cycles to extract sEMG signals of the classified side. 1). 0000012664 00000 n JUMP GAIT - GENERAL I. This experienced clinician followed gait patterns definitions from literature,8 and had an intrarater reliability of k=0.766 (unweighted; 95% confidence interval: 0.65–0.87). There is often a stiff knee because of rectus femoris activity in the swing phase of gait. 11. Jump Gait (With or Without Stiff Knee) 4.3 Type 3. 0000013096 00000 n endobj It means that with the increase of age, the pattern of gait shifted from true equinus and jump gait to apparent equines . B$a Å- bH!¶pHæ¹ßtgE¤øæ`reäa18à DL®0;ð2(u9ç rSÆ ÁA)ðõ@)C'8¶pðp %PDF-1.3 %âãÏÓ For the post hoc t-test, maximal effect size was 1.42 with a sample size of 10 children. This landmark volume will be of special interest to anyone involved in rehabilitation science and engineering: federal policymakers, rehabilitation practitioners and administrators, researchers, and advocates for persons with disabilities. Human gait refers to the repetitive locomotion pattern of how a person walks. Sagittal plane barefoot video from the baseline visit was viewed to classify type of gait pattern according to the criteria described by Rodda et al 14 (eg, jump, equinus, or crouch) by observation of shoes-only gait at midstance. Over-correction may lead to calcaneal gait that predisposes to crouch gait, which is a major concern. However, within these generic movement patterns, our children with CP showed individualized motor control strategies. This means that the heel strike of the left foot should occur exactly halfway between heel strike of the right foot at the start of the gait cycle and heel strike of the right foot at No significant differences were found between the gait patterns regarding synergy activations (stance phase synergy: SnPM[F]=4.782, push-off synergy: SnPM[F]=4.729, swing phase synergy: SnPM[F]=4.792). 0000011134 00000 n combined motions of the different lower limb joints): drop foot, genu recurvatum, apparent equinus, crouch gait, jump gait, and true equinus. Antalgic Gait. 1. xÚb```f`àüÇÀÎÀ `Ï È l@Qu6YbüXe5²LÔôr4ûÅs¨èäÒ¹åÄÆËå}yñ{K_oçX¾ÌÛÑi¦ðª°YæA*Û>³©çÉÝÙ]õWÊýâ¶êeïeöóñh\Ù]õOG?ÑÚzÄíJÞ×óôb÷W©X,´tæù\²qWÑÇ=ýÖ ||>¿SM*gémy÷ôIûº'G The foot is in plantar flexion with a tibial-tarsal angle always greater than 90°, especially at the end of support. It covers the fundamentals, normal gait, pathological gait, clinical considerations, advanced locomotor functions, and gait analysis systems. by A. Berthoz The publication of this volume, edited by Adriano Ferrari and Giovanni Cioni, is a major event for several reasons. 0000007200 00000 n and you may need to create a new Wiley Online Library account. Compensated crouch gait • refers to tertiary deviations that allow the knee extensor mechanism to be off-loaded during stance phase (e.g. Synergies and gait patterns can both reflect an individual’s motor control strategy. May present with "stiff knee gait" from hamstring quadriceps co-contraction. In case of doubt, a senior clinician was consulted. 0000007516 00000 n crouch gait pattern may have a rectus transfer goal of maintaining peak knee flexion, whereas another with a jump knee pattern may need to increase the amount of peak knee flexion in swing. 7. The parents of the children gave informed consent. Refers to the collection of quantitative data of the gait cycle, such as videography, kinematics, kinetics, oxygen consumption, and electromyography.. Three-dimensional instrumented gait analysis has helped to increase our knowledge of gait pathology and treatment. Found inside – Page 123Common compensatory strategies in jump gait include vaulting and circumduction. In crouch ... Ambulation with bilateral AFOs, which the client prefers, increases step length and reduces knee flexion compared with ambulation with no ... The EMGs were classified with ‘good quality’ when there was obvious phasic activity and/or when low frequency or high amplitude artifacts were filtered out. gait deviations at ankle. To be able to differentiate between crouched gait and jump gait. The limitation performance of . The reliability of this classification of sagittal gait pat- As a PC2 increases, the positive variables on the top also Purpose:Synergistic neuro-excitability in the lower extremities may be related to gait disorders. of onset of an acute process, and is a better measure than ESR. Use the link below to share a full-text version of this article with your friends and colleagues. painful (antalgic) gait may occur if patient is protecting an injury to the foot, ankle, knee hips or pelvis. Early and late recurvatum occur in the first and second halves of stance. The medial gastrocnemius weights of the apparent equinus (1.21 [0.37]) and jump gait (1.25 [0.31]) patterns were significantly lower than for the minor deviations pattern (1.48 [0.36]; p<0.001 and p<0.01 respectively, Fig. 2). ?�,�� �q�t�I�nW�g��_���fއo�&S�}�p�w���N��n?��]�2T��"C����2�1�]�b�X�V%NW����EI��x�>a�;l- Save Share. For example, most children with CP walk with abnormal gait patterns such as equinus or crouch gait . 0000002975 00000 n 0000016000 00000 n Data of good quality were assigned a weight of one. There are however, different definitions of . Early recurvatum is associated with dynamic calf contraction that raises the heel and . Unfortunately, improvements in muscle strength and gait are inconsistent after co. . This cross-sectional retrospective study was approved by our local ethics committee (Commissie Medische Ethiek KU Leuven; S56036) under the Declaration of Helsinki. Bilateral true equinus The true equinus group did not meet the sample size requirements and was excluded, leaving 188 children for subsequent analyses (mean age: 9y 5mo . 0000004225 00000 n None of the parameters had a normal distribution. 0000013459 00000 n 0000006111 00000 n The rectus femoris and tibialis anterior were mostly active in the swing phase synergy. 1) are all alterations in sagittal kinematic coronal planes. Provides a broad overview of current rehabilitation approaches, emphasizing the need for interdisciplinary management and focussing on deliverable outcomes. Monocentric, clinically prospective intervention study. of 1%) in an SnPM analysis can be unstable, we excluded clusters smaller than 5% of the gait cycle in length. The height of the centre of mass at take-off (H t) was estimated by the height of the sacrum marker measured from the videos.The take-off velocity (V t) was calculated from the 3D displacement of the sacrum marker.The sacrum marker approximates of the centre of mass (Marsh & John-Alder 1994).For the bound take-off calculation the take-off velocity . 0000009255 00000 n This is an important consideration for energy conservation Found inside – Page 395Sagittal gait patterns: spastic diplegia Group I true equinus Group II jump gait Group III apparent equinus Group IV Group V crouch gait asymmetric gait R L α > 90° For example gastroc - - Apparentequinus hinged AFO α > 90° gastroc ... 0000009669 00000 n nus, crouch gait, jump gait, or true equinus. Diagnosis is made clinically with evaluation of developmental milestones, cognitive function, and musculoskeletal abnormalities . Found inside – Page 126MG demonstrates a much reduced stance time on the affected side (62% gait cycle) versus the sound side (71% gait ... than do patients with crouch gait but with excessive ankle dorsiflexion rather than plantar flexion.120 Jump gait is ... At the initial visit, most limbs were in either true equinus (30 %) or jump-knee gait (26.5 %). Muscle synergies are repeatable between days and across walking speeds in CP.17, 24 Therefore, we believe that the differences in synergy weights between the gait patterns and the high variability in synergy structure between our participants are associated with individualized motor control strategies. %PDF-1.5 2). Synergies may reflect unique control strategies related to an individual’s impairments. Synergy structure is similar between gait patterns in cerebral palsy (CP). over 0-4% of the gait cycle) or terminal swing (averaged over 96-100% of the gait cycle) preoperatively. 0000012929 00000 n Found insideKnee patterns in spastic diplegia have been classified as recurvatum knee, jumpknee,stiff knee,and crouch(128).Theknee classification hasbeen extended to the sagittal plane as true equinus, jump gait,apparentequinus, and crouch gait ... Found inside – Page 532Crouch gait, a common walking pattern in individuals with cerebral palsy, is characterized by excessive flexion of the hip and knee. Many subjects with crouch gait experience knee pain, perhaps because of elevated muscle forces and ... C-reactive protein (CRP) rises within 6 hours. <>>> An overview of the kinematics of the gait patterns is given in Figure 1, as well as representative videos of each gait pattern (see Videos S1–S7, online supporting information). crouch gait: ankle, knee, and hip in excess flexion throughout gait, normal or posterior pelvis. Hemiplegic Gait. 0000012873 00000 n So to get him back in a 4 beat gait, I would tip his nose in towards the rail and at the same time put pressure with my heel right behind the girth to open up his shoulder. 4.19). 0000003177 00000 n The family physician can see patients with tethered . For the Gait Variable Scores (GVS) a reduction of the index means an improvement. The differences between gait patterns are related to the amount and timing of muscle activity during walking.7 Therefore, we expect that differences in synergy structure will be more evident when children with CP are grouped based on their gait patterns, instead of functional level or topographical type. In the final episode of CP Spastic Diplegia Gait series, this video describes the complex Crouch gait pattern and the management. 2) Jump Gait Pathomechanism: the ankle is in equinus, the knee and hip are in flexion, there is an anterior pelvic tilt and an increased lumbar lordosis. Found insideTrue Equinus Gait In true equinus gait, inadequate dorsiflexion through the ankle joint shifts first contact ... and can lead to excessive dorsiflexion, weakness in plantar flexion, and iatrogenic progression into the crouch gait. Gait & Posture, 2006. have been determined when applying normal gait and pathological crouch and jump postures, imitated by healthy adults and children. |)Y�?�%_�?��Tx�I�ml.���4������*��������� �ͱk�����RZ�������0:�{�#~? The sEMG signals were rectified and smoothed with a fourth order Butterworth lowpass filter with a 10Hz cut-off frequency. (2004) suggested that apparent equinus and crouch gait were seen in children who were 2.9 years older than those with true equinus and jump gait . KS and BS were supported by the National Institutes of Health (grant number R01NS091056). 0000012380 00000 n Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Normality of the synergy weights and walking speed was checked with a Shapiro–Wilk test. A body will move with a constant velocity until it experiences a net force (Newton's First Law).A change in body motion is achieved by initiating muscle contraction in order to apply a force against another object, such as the floor or the wall. Found inside – Page 164Based on the classification by Rodda et al (2004), Ruby had a jump gait pattern. ... IV Crouch gait α <90° – Hamstrings/RF Psoas GRAFO Group V Asymmetric gait FOR EXAMPLE R L Apparent equinus Jump gait Figure 10.3 Sagittal gait patterns ... Crouch Gait • Increased hip flexion • Increased knee flexion • Increased ankle dorsiflexion (calcaneous) • Usually iatrogenic. Design . Found insideThe development of gait in children with cerebral palsy (CP) is substantially different from their able-bodied peers due to ... common gait deviations have been described: scissoring, jump, crouch, stiff-knee gait, and equinus (34,35). One limb per subject, EP was supported by the SIMCP IWT-project (Agentschap voor Innovatie door Wetenschap en Technologie), a simulation platform to predict gait performance after orthopedic intervention in children with CP (IWT 140184), the Flemish Research Council (grant number T003116N), and the KU Leuven Internal Funds C24M/19/064. We compared synergy activations and weights between the patterns. 0000054596 00000 n 2). Part of this database has already been published online.9 Inclusion criteria were: (1) children diagnosed with unilateral or bilateral spastic CP; (2) in GMFCS level I to III; (3) 3D gait analyses recorded after 2010 to reduce the influence of different data collection methods; (4) surface electromyography (sEMG) recordings of minimally one gait cycle with sufficient quality of at least one muscle representing the following groups: knee extensors, knee flexors, dorsiflexors, plantar flexors, and hip abductors; and (5) no history of orthopaedic or neurosurgery in the year before the 3D gait analyses or botulinum neurotoxin A injections 6 months before the 3D gait analyses. 0000003853 00000 n Jump Gait • In di or hemiplegia • Increased hip flexion • Increased knee 0000037355 00000 n [2] Rodda et al. Collection occurs when a horse's center of gravity is shifted backwards. To be able to assess range of motion of the foot and ankle, and the severity of gait deviation for patients with crouched gait/excess dorsiflexion. If you do not receive an email within 10 minutes, your email address may not be registered, painful (antalgic) gait may occur if patient is protecting an injury to the foot, ankle, knee hips or pelvis. To determine if muscle synergy structure (activations and weights) differs between gait patterns in children with spastic cerebral palsy (CP). Crouch gait • Jump gait • Stiff knee gait • Recurvatum gait. 0000003946 00000 n 5 a, showing the knee angle as a function of the gait cycle for a number of increasing crouch angles. This book focuses on the comprehensive approach to understanding children with cerebral palsy and beyond, to the care extended to their families, to the patient's educational life as well as to their very unique being and identity. 0000009190 00000 n have the dog checked over to rule out an injury (even a developing hidden one) vs. anatomy. Variability in synergy structure between participants was high. 0000055234 00000 n To date there is only limited knowledge about the wearing time of orthoses. The most frequent gait pattern was apparent equinus (n=53), followed by crouch gait (n=39), minor deviations (n=34), genu recurvatum (n=26), jump gait (n=20), drop foot (n=16), and true equinus (n=7). Found inside – Page 126MG demonstrates a much reduced stance time on the affected side (62% gait cycle) versus the sound side (71% gait ... ambulate with a jump gait pattern, using somewhat less hip and knee flexion than do patients with crouch gait but with ... 5. This book serves as an essential companion to orthopedic surgeons, general practitioners, and professionals as well as being a welcome addition in pediatric orthopedic clinics. This decreased complexity of motor control has been quantified by a higher total variance accounted for by one synergy (tVAF1).5 In CP, tVAF1 is related to impairment level, with increased values of tVAF1 in children in higher Gross Motor Function Classification System (GMFCS) levels.5, Yu et al. We selected 230 children with CP. Stiff-knee gait and crouch gait are among the most common gait problems in ambulatory patients with cerebral palsy (CP) [1, 2].Stiff-knee gait results in limited flexion and extension of the knee, and a restricted arc of motion during the swing phase [].Crouch gait, a major sagittal plane deviation, is defined as excessive ankle dorsiflexion combined with knee and hip flexion during the stance . In superbly crafted writing that burns with intensity, award-winning author Markus Zusak, author of I Am the Messenger, has given us one of the most enduring stories of our time. “The kind of book that can be life-changing.” —The New ... See Tweets about #crouchgait on Twitter. Jump gait - Combination of knee flexion and ankle equinus b. Spasticity is the result of disrupted communication between the brain and muscles. 0000003292 00000 n R26.1 Paralytic gait. 0000037144 00000 n E-mail: m.goudriaan@vu.nl, Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium, Clinical Motion Analysis Laboratory, University Hospitals Leuven, Pellenberg, Belgium, Department of Mechanical Engineering, University of Washington, Seattle, WA, USA, Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA, Department of Development and Regeneration, University of Leuven, Leuven, Belgium, Department of Orthopedics, University Hospitals Leuven, Leuven, Belgium. These most commonly observed pathological gait patterns in children with CP focus on deviations in the sagittal plane, and show a good intrarater reliability.8 An additional (seventh) ‘minor deviations pattern’ was added to accommodate for children with milder deviations.8, 9 These seven gait patterns have shown acceptance by the clinical CP community.8. approximately 62% of the complete gait cycle (100%). 0000014848 00000 n The data that support the findings of this study are openly available in [figshare] at http://doi.org/10.6084/m9.figshare.13123175. For the SnPM analyses, the number of iterations was set at 10 000. ‐found average cost of a single event multilevel surgery was cut in half by using gait analysis when compared to a staged HTËnÛ0¼ë+x¤xÍåÇ´A_HPÖ-èA[ ,¥ ý~nW¤Ý¤ÕB½"¹»³3C-Þõ=ñéË6[|X"[÷ÙÌ(ð^ª¸céÓǬ7¼FVn³Å§-².»¦oA£yc. Biomechanical markers include: increased flexion in the lumbo-sacral joint, stifle, and hocks of the horse; increased engagement of the thoracic sling muscles resulting in the withers rising relative to . variable, or crouch gait.4,5 Crouch gait was defined as in-creased hip and knee flexion and ankle dorsiflexion through-out the stance phase. 0000006266 00000 n Vicon-UK, Oxford, UK). 0000013250 00000 n In Stage 2, 13 experts from eight gait laboratories (four in the USA . However, significant differences in rectus femoris and vastus lateralis weights between gait patterns in the push-off synergy should be interpreted with some caution. 3. 0000006499 00000 n jump higher and lift more weight. 1 equinus, 2 jump knee, 3 crouch knee, 4 stiff knee. Learn about our remote access options, Department of Human Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands, Correspondence to Marije Goudriaan at Vrije Universiteit Amsterdam, Department of Human Movement Sciences, Van der Boechorststraat 7–9, 1081 BT Amsterdam, the Netherlands. For both patterns, tVAF1 could be similar, but the gait kinematics of these two patterns differ. ¦ÜüvzÒTaÖåÓb[ö`®«¦¿çécïæí.´ëebq ¹PIIɸ00¦eÀ9Æ&. 0000054951 00000 n Over-correction has been reported in 0-36% of children following calf muscle lengthening . x��Z]o۸}���G�b���(J@�M��ݢM����*r,Ė���m����6i����H�*�!y8s�b�٫W��e��%{�����=?���v;? 14 Contracture. The jump gait is defined as a knee bending disorder at the time of the ground attack by the foot. 7.Gait Biomechanics & Analysis - View presentation slides online. Cerebral Palsy is a common congenital condition caused by injury to the immature brain that leads to upper motor neuron disease and presents with cognitive and musculoskeletal manifestations of varying severity. classified the gait patterns in . 0000004938 00000 n The number of gait cycles used for gait pattern classification varied between two and nine per participant. However, the differences in weights and high variability between participants indicate that this generic motor control strategy might be individualized and dependent on impairment level. Crouch gait is a common abnormality in cerebral palsy, with the primary feature being excessive knee flexion during the stance phase of gait. found differences in synergy activations and weights between different topographical types (e.g. R26.81 Unsteadiness on feet. Energy expenditure definitions specific to mobility include Physiologic cost of gait or transport, defined as VO 2 /walking speed (ml/kg/m), and Physiologic efficiency of gait, defined as energy expenditure [(subject)/ (normal gait)]. . The inclusion of zero weighted signals has a limited effect on tVAF1 and synergy structure.13, 14 However, it allows for the inclusion of participants with poor quality or missing sEMG signals, thereby reducing the chance of selection bias. There are eight basic pathological gaits that can be attributed to neurological conditions: hemiplegic, spastic diplegic, neuropathic, myopathic, Parkinsonian, choreiform, ataxic (cerebellar) and sensory. endobj At maturity, crouch gait (52.5 %) was the most common classification, of which 47.6 % were mild (1-3 standard deviations from age-matched norm; 21°-30°) and 52.4 % moderate or severe. The 3D gait analyses of the remaining 195 children were grouped per gait pattern (Table 1). In this equation, n is the number of synergies (one to five), m is the number of muscles (eight), t is the number of data points of the concatenated signal (404), and error is the difference between the measured sEMG and reconstructed muscle activity signals computed using the corresponding synergy structure.15 Next, we used k-means cluster analysis on the synergy weights to group similar synergies between the gait patterns.16 Additionally, we determined tVAF1 for each pattern. In this cross-sectional study, we classified 188 children with unilateral (n=82) or bilateral (n=106) spastic CP (mean age: 9y 5mo, SD: 4y 3mo, range: 3y 9mo–17y 7mo; 75 females; Gross Motor Function Classification System [GMFCS] level I: 106, GMFCS level II: 55, GMFCS level III: 27) into a minor deviations (n=34), drop foot (n=16), genu recurvatum (n=26), apparent equinus (n=53), crouch (n=39), and jump gait pattern (n=20).
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