Identification of kinematic motifs in crouch gait of children with cerebral palsy
Abstract
Crouch gait is among the most disabling gait deviations in cerebral palsy (CP). Powered exoskeletons can supply the extensor thrust orthoses cannot, but their control depends on repeatable kinematic patterns, and crouch gait is perceived as irregular. Five children with CP (8–14 years; Gross Motor Function Classification System [GMFCS] I–III) walked at self-selected speed wearing bilateral shank inertial measurement units, knee goniometers and insole pressure sensors at the heel and forefoot. Signals were filtered with a two-state Kalman filter, adaptively segmented into gait cycles using plantar-pressure events (heel or toe strike), and time-normalised to 101 points. A kinematic motif was defined as a limb’s ensemble waveform and validated using the coefficient of variation, ICC(3,1), dynamic time warping, autocorrelation and 1,000-iteration permutation testing; symmetry was quantified with the Symmetry Index. Repeatability tracked the signal measured rather than functional severity: mean ICC(3,1) was 0.76 for forefoot loading, 0.61 for heel loading and 0.29 for knee kinematics. Full criteria were met in 12 of 30 limb–signal combinations, 12 met one or two, and 6 met none. Five of the six failures were knee channels, also the only channels indistinguishable from a permuted null, yet the knee met all criteria bilaterally in the least affected participant. These preliminary findings establish feasibility in a heterogeneous cohort ( n = 5); no gait-phase classifier was trained or evaluated here.
Related
- Predictive Contribution of Clinical Measures of Ankle Neuromuscular Impairments to Ankle Kinematic Deviations During Gait in Children With Cerebral Palsy.
- Identification of Genes Associated with Gut Microbiota Metabolites in Type 2 Diabetes Mellitus Complicated by Acute Cerebral Infarction Based on Bioinformatics and Mendelian Randomization
- Therapists' perspectives on the use of an overground lower-limb exoskeleton in physiotherapy sessions for minimally ambulatory children with cerebral palsy: a qualitative study
- Neurite orientation dispersion and density imaging for preoperative evaluation of cerebral microstructure and neurodevelopment in children with congenital heart disease
- Components of service delivery for the detection, care and management of children with cerebral visual impairment: a scoping review.
BibTeX
@article{krishnan2026identification,
title = {{Identification of kinematic motifs in crouch gait of children with cerebral palsy}},
author = {Shyam Krishnan K and Manish C. Poojari and Abhishek Kumar and C. M. C. Krishnan and B. Unnikrishnan and Abraham M. Joshua and Sheron Figarado and Megha M. Nayak},
journal = {Scientific Reports},
year = {2026},
month = oct,
doi = {10.1038/s41598-026-73237-9},
url = {https://www.nature.com/articles/s41598-026-73237-9},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Identification of kinematic motifs in crouch gait of children with cerebral palsy
AU - Shyam Krishnan K
AU - Manish C. Poojari
AU - Abhishek Kumar
AU - C. M. C. Krishnan
AU - B. Unnikrishnan
AU - Abraham M. Joshua
AU - Sheron Figarado
AU - Megha M. Nayak
PY - 2026
DA - 2026/10/17
JO - Scientific Reports
DO - 10.1038/s41598-026-73237-9
UR - https://www.nature.com/articles/s41598-026-73237-9
AB - Crouch gait is among the most disabling gait deviations in cerebral palsy (CP). Powered exoskeletons can supply the extensor thrust orthoses cannot, but their control depends on repeatable kinematic patterns, and crouch gait is perceived as irregular. Five children with CP (8–14 years; Gross Motor Function Classification System [GMFCS] I–III) walked at self-selected speed wearing bilateral shank inertial measurement units, knee goniometers and insole pressure sensors at the heel and forefoot. Signals were filtered with a two-state Kalman filter, adaptively segmented into gait cycles using plantar-pressure events (heel or toe strike), and time-normalised to 101 points. A kinematic motif was defined as a limb’s ensemble waveform and validated using the coefficient of variation, ICC(3,1), dynamic time warping, autocorrelation and 1,000-iteration permutation testing; symmetry was quantified with the Symmetry Index. Repeatability tracked the signal measured rather than functional severity: mean ICC(3,1) was 0.76 for forefoot loading, 0.61 for heel loading and 0.29 for knee kinematics. Full criteria were met in 12 of 30 limb–signal combinations, 12 met one or two, and 6 met none. Five of the six failures were knee channels, also the only channels indistinguishable from a permuted null, yet the knee met all criteria bilaterally in the least affected participant. These preliminary findings establish feasibility in a heterogeneous cohort ( n = 5); no gait-phase classifier was trained or evaluated here.
SN - 2045-2322
ER -