Can biomechanical variables predict improvement in crouch gait?

Jennifer L. Hicks, Scott L. Delp, Michael H. Schwartz

Research output: Contribution to journalArticlepeer-review

49 Scopus citations


Many patients respond positively to treatments for crouch gait, yet surgical outcomes are inconsistent and unpredictable. In this study, we developed a multivariable regression model to determine if biomechanical variables and other subject characteristics measured during a physical exam and gait analysis can predict which subjects with crouch gait will demonstrate improved knee kinematics on a follow-up gait analysis. We formulated the model and tested its performance by retrospectively analyzing 353 limbs of subjects who walked with crouch gait. The regression model was able to predict which subjects would demonstrate 'Improved' and 'Unimproved' knee kinematics with over 70% accuracy, and was able to explain approximately 49% of the variance in subjects' change in knee flexion between gait analyses. We found that improvement in stance phase knee flexion was positively associated with three variables that were drawn from knowledge about the biomechanical contributors to crouch gait: (i) adequate hamstrings lengths and velocities, possibly achieved via hamstrings lengthening surgery, (ii) normal tibial torsion, possibly achieved via tibial derotation osteotomy, and (iii) sufficient muscle strength.

Original languageEnglish (US)
Pages (from-to)197-201
Number of pages5
JournalGait and Posture
Issue number2
StatePublished - Jun 2011

Bibliographical note

Funding Information:
The authors thank the staff of the Center for Gait and Motion Analysis at Gillette Children's Specialty Healthcare for collection of the subject data and Trevor Hastie for providing technical guidance on the statistical analysis techniques. This work was funded by the National Institutes of Health through the NIH Roadmap for Medical Research , Grant U54GM072970 and through NIH Grants HD33929 , R24 HD065690 , and HD046814 . Support was also provided by Stanford's Bio-X program . Conflict of interest statement


  • Biomechanics
  • Cerebral palsy
  • Crouch gait
  • Modeling
  • Surgical outcomes


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