Thought I’d try a video blog for a change to show you how I’ve been using e-Verne to explore the kinematics of crouch gait with some counter-intuitive findings.
If you want to learn more you can skip to my YouTube screencast on what determines adequate step length and another one on how clearance is achieved (or go to my YouTube channel).
Fascinating looking at Verne and his swinging! My only comment is that in CP the ankle invariably does not remain at plantegrade during swing, rather it drops into plantarflexion which will increase the need for knee and hip flexion of the swing limb. Have you tried inputting this to the calculations?
That’s the advantage with Verne – you don’t need any calculations you can just go and try it out. Put Verne in the pose that you think your patients adopt and see what difference movement at the different joints make.
As regards those crouch patients my feeling is that the majority have quite limited ankle movement through stance and swing. This is born out to a certain extent by Jill Rodda’s paper on sagittal plane gait patterns which suggests that those children in what she labels as “crouch” (bent knees and dorsiflexed ankles in stance) don’t actually show that much plantarflexion in swing. It is generally those who are have ore plantarflexion in middle and late stance who tend to go into plantarflexion during swing. Again it would be quite easy to place Verne in the pose’s adopted by the average child from Jill’s paper and investigate how easy it is for them to achieve clearance by moving different joints.
Rodda, J. M., Graham, H. K., Carson, L., Galea, M. P., & Wolfe, R. (2004). Sagittal gait patterns in spastic diplegia. Journal of Bone and Joint Surgery. British Volume, 86(2), 251-258.