Gait in the Child With Hemiplegia

Gait refers to the controlled manner of walking or moving on foot. The functioning of the nervous system and the musculoskeletal system determines the gait pattern. In children who have hemiplegia, this delicate system is out of balance and often results in different types of gait.

Gait in the Child with Hemiplegia

A child with hemiplegia may have a tendency to walk with the toes on the affected foot striking the ground first, instead of the usual heel strike. This “toe drop” often results in our kids taking quite a few falls and tumbles. In order to clear the toe while walking, the child may develop a variety of ways to compensate, which then result in problems with his hip and or knee. Treatments may include gait analysis, physical therapy, orthotics, serial casting, botulinum toxin and surgery. The goal of treatment is not to “cure” the condition, but to enable the child to achieve her maximum potential.

Why does my daughter’s affected leg look shorter than her other leg?

Leg length differences, also known as leg length discrepancies (LLD) are commonly seen in children who have spastic hemiplegic cerebral palsy. One study looked at teens and young adults with hemiplegic cerebral palsy and researchers found that in more than 25 percent of the individuals with hemiplegia the affected leg was 15 millimeters shorter than the other leg. They reported that the main difference between the side with hemiplegia and the unaffected side was found in the tibia, also known as the shinbone. The larger the difference in leg length, the more your child has to compensate by changing her posture and walking pattern. This change in walking pattern, or gait, can lead to a variety of problems with the hip, knee, ankle, and sometimes back (scoliosis). Sometimes a child’s leg may appear to be shorter, but the difference is due to spastic muscles, pulling the leg up higher towards the hip. Your child’s orthopedic surgeon, physical therapist, and orthotist can follow your child to watch for differences in leg length and make suggestions for therapy, orthotics (braces), or in rare cases, surgery.