Issue 25-2, 2026

Original article

https://doi.org/10.38025/2078-1962-2026-25-2-42-52

Gait in Children Aged 10–13 Years with Spastic Diplegia after Multilevel Orthopedic Interventions: A Retrospective Study

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ORCIDTamara I. Dolganova1,*, ORCIDOrkhan I. oglu Gatamov2, ORCIDAkhmed D. Tomov3, ORCIDDmitry V. Dolganov1, ORCIDOrifzhan F. Nasipzhanov1, ORCIDDmitry A. Popkov1

1National Ilizarov Medical Research Centre for Traumatology and Ortopaedics, Kurgan, Russia
2 Federal Scientific and Clinical Center for Medical Rehabilitation and Balneology of the Federal Medical and Biological Agency, Moscow, Russia
3 Priorov Central Institute for Trauma and Orthopaedics, Moscow, Russia


ABSTRACT

INTRODUCTION.  Simultaneous or sequential bilateral multilevel orthopedic interventions are methods for choosing surgical orthopedic correction.

АIM.  To determine patterns of change in kinematic and kinetic gait parameters in children with spastic diplegia who underwent multilevel bilateral orthopedic surgery in early adolescence.

MATERIALS AND METHODS.  A retrospective study of 68 patients with cerebral palsy (CP) was conducted at the National Ilizarov Medical Research Centre for Traumatology and Ortopaedics (Kurgan, Russia) from January 2018 to March 2025. Groups: I patients who had not previously undergone lower limb muscular surgery (n = 38); II patients who had undergone triceps brachii surgery (n = 30); subgroups: A GMFCS level I–II, B GMFCS level III. Kinematic data were recorded using Qualisys 7+ optical cameras synchronized with six KISTLER dynamometric platforms (Kistler Group, Switzerland).

RESULTS.  Statistically significant differences were found between the groups for the support impulse during the period of 1–2 years after the surgery, when the contraction power in previously unoperated patients with GMFCS levels I–II was 40–50 % higher. Following the surgery, there is an increase in total muscle contraction power after a period of 3–4 years; however, GMFCS level iii in group 2 remains reduced by 20 %.

DISCUSSION.  The results confirm an improvement in the integrated gait performance (GPS) for all groups. A decrease in walking speed, combined with an increase in the double-support period of the gait cycle, is a negative aspect of gait evolution. An unfavorable factor, combining age and surgical aspects, is the performance of fibromyotenotomies, fibrotomies, and Achilles tendon lengthening at an early age, when muscle retractions have not yet developed.

CONCLUSION.  In children with GMFCS Levels I–II and without early muscular interventions, there is an evolution of gait parameters concomitant with an increase in walking speed and improvement in kinematic and kinetic parameters. In children with GMFCS Levels I-II after triceps surae interventions and GMFCS Level III, no increase in walking speed has been observed during the rehabilitation. The coupled dynamics of speed and power parameters of gait reflected adequate energy supply of the biomechanics of movements.


KEYWORDS: cerebral palsy, multilevel interventions, long‑term outcomes, adolescents

FOR CITATION: [Dolganova T.I., Gatamov O.I., Tomov A.D., Dolganov D.V., Nasipzhanov O.F., Popkov D.A. Gait in Children Aged 10–13 Years with Spastic Diplegia after Multilevel Orthopedic Interventions: A Retrospective Study. Bulletin of Rehabilitation Medicine. 2026; 25(2):42–52. https://doi.org/10.38025/2078‑1962‑2026‑25‑2‑42‑52 (In Russ.).

FOR CORRESPONDENCE:

Tamara I. Dolganova, E‑mail:  rjik532007@rambler.ru,  office@rncvto.ru

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This is an open article under the CC BY 4.0 license. Published by the National Medical Research Center for Rehabilitation and Balneology.