Objective. To determine if gait waveform could discriminate children with diplegic cerebral palsy of the GMFCS levels I and II. Patients. Twenty-two children with diplegia, 11 classified as level I and 11 as level II of the GMFCS, aged 7 to 12 years. Methods. Gait kinematics included angular displacement of the pelvis and lower limb joints during the stance phase. Principal components (PCs) analyses followed by discriminant analysis were conducted. Results. PC1s of the pelvis and hip in the frontal plane differ significantly between groups and captured 80.5% and 86.1% of the variance, respectively. PC1s captured the magnitude of the pelvic obliquity and hip adduction angle during the stance phase. Children GMFCS level II walked with reduced pelvic obliquity and hip adduction angles, and these variables could discriminate the groups with a cross-validation of 95.5%. Conclusion. Reduced pelvic obliquity and hip adduction were observed between children GMFCS level II compared to level I. These results could help the classification process of mild-to-moderate children with diplegia. In addition, it highlights the importance of rehabilitation programs designed to improve pelvic and hip mobility in the frontal plane of diplegic cerebral palsy children level II of the GMFCS. 1. Introduction Cerebral palsy is a nonprogressive central nervous system disorder that results in physical impairments and functional limitations that change as the children grow older [1]. Among a large number of instruments [2–4], for measuring the physical ability of children with CP, the Gross Motor Function Classification System (GMFCS) introduced by Palisano et al. in 1997 [5] has been widely applied in clinical and research settings [6]. The GMFCS is a five-level classification system that identifies abilities and functional limitations, based on the need of assistive devices of the cerebral palsy child, during self-initiated movements, such as walking and sitting [5]. The system application is quick and easy and it gives a brief description of which level the child resembles based on his/her current gross motor function. The reliability and validity of the GMFCS in differentiating cerebral palsy children with different functional levels have been reported [1]. Similarly, the stability of the system over time proved to be very consistent, suggesting that the GMFCS could be used routinely in clinical practice to follow children with cerebral palsy [7]. However, due to the heterogeneous nature of cerebral palsy, some overlap between levels I and II has been observed and, indeed,
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