Deformity of the Forefoot in Children With Unilateral Cerebral Palsy

Study Overview
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Brief Summary
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Midfoot and backfoot deformities are well described in children with Cerebral palsy. However, data regarding forefoot deformities in Cerebral palsy remain scarce in a population were foot deformities are the most frequent musculo-skeletal deformities.

Detailed Description
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Foot deformities are the most frequent musculo-skeletal deformities in children with Cerebral palsy. Pain starts in the foot, especially during gait in Cerebral Palsy Children (GMFCS I and II) and induce gait limitations, balance disorders, wounds, aesthetic disorders and difficulties to support shoes. Metatarsus Adductus is the most common foot deformity in children with or without disorder, occuring on 1-2/1000 births. In 4 to 14% of the children, evolution is not favorable at 5 years. In that case, the diagnostic of Cerebral palsy have to be considered.

Official Title
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Deformity of the Forefoot in Children With Unilateral Cerebral Palsy

Conditions
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Forefoot Adductus, Cerebral Palsy

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Child who benefit a standardised clinical evaluation before a 3D Gait Analysis with forefoot deformity measure Child age less than 18 years old Child with left or right unilateral cerebral palsy Walking child ( GMFCS score I, II or III) In case of several 3D Gait Analysis for the child: the 3D gait analysis was chosen first before any local spasticity treatment with botulinic toxin injection or the 3D gait evaluation the more far from local spastica treatment with botulinic toxin injection was chosen in second . Exclusion Criteria: Hemiplegia due to another etiology History of lower limb or foot surgery before the clinical evaluation Local spasticy treatment with botulinic toxin injection less than 3 months before the clinical evaluation Participation refusal

Ages Eligible for Study
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Minimum Age: 2 Years
Maximum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Measure of the forefoot deformity prevalence in plegia and non-plegia foot during gait in unilateral cerebral palsy children | we report in our population the forefoot axis measured by the angle between the heel bisector and the axis between the second and third metatarsal. | 1 day | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Anthropometric factors (age) associated with forefoot deformities on plegia side in walking children with unilateral Cerebral Palsy. | we report the age (years mean, standard deviation) of the patients CP | 1 day | 
| Anthropometric factors (sexe) associated with forefoot deformities on plegia side in walking children with unilateral Cerebral Palsy. | we report the sexe of the patients (female or male) | 1 day | 
| Anthropometric factors (type of cerebral palsy)associated with forefoot deformities on plegia side in walking children with unilateral Cerebral Palsy. | we report the plegia side of the patients cerebral palsy : right or left | 1 day | 
| functional factors associated with forefoot deformities on plegia side in walking children with unilateral Cerebral Palsy. | we report the GMFCS score of the patients cerebral palsy : GMFCS 1, 2, 3, 4 or 5 (4-5 non ambulant 1-3 ambulant children) | 1 day | 
| biomechanical osteoarticular factors associated with forefoot deformities on plegia side in walking children with unilateral Cerebral Palsy. | we report biomechanical osteoarticular factors : hindfoot axis, foot dorsiflexion, footprint, tibial torsion, femoral antetorsion, leg length inequality) , Spasticity of lower limb muscle (Modified Ashworth Scale and Tardieu Scale) and Motricity of lower limb muscle ( Boyd scale and MRC evaluation) | 1 day | 
| Spasticity factors associated with forefoot deformities on plegia side in walking children with unilateral Cerebral Palsy. | we report the Spasticity of lower limb muscle (Modified Ashworth Scale and Tardieu Scale) | 1 day | 
| Motricity factors associated with forefoot deformities on plegia side in walking children with unilateral Cerebral Palsy. | we report the motricity of lower limb muscle ( Boyd scale and MRC evaluation) | 1 day | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Cerebral Palsy, Forefoot Deformity