Natural history of gait patterns in untreated children with bilateral cerebral palsy in a low-income country setting.

Aim: To assess a group of ambulant, untreated children with bilateral spastic cerebral palsy, in a resource-poor setting, who had never been assessed by a health care professional or received any treatment, to help establish the natural history of gait patterns in this condition.

Method: At CURE Children's Hospital of Ethiopia, 46 children with no prior health care contact were assessed in a cross-sectional cohort study, through a detailed history, clinical examination, and instrumented gait analysis using a motion capture system.

Results: There was a large spread in the data reflecting the high natural heterogeneity in this population. The severity of gait pathology did not correlate with age; however, a small but significant reduction in sagittal hip and knee range of motion with increasing age was observed. There was also a trend towards reduced passive knee extension with age.

Interpretation: Improved understanding of the aspects of gait that are likely to naturally improve, deteriorate, or remain stable over time helps guide treatment decisions in this population.