For children with spastic cerebral palsy (CP), one of the most common movement disorders, walking can be a daily challenge. Gait abnormalities—driven by factors such as muscle weakness, shortened muscle-tendon units or impaired motor control—limit mobility and independence. Identifying these root causes is essential for effective treatment, yet the gold standard—3D motion capture analysis—is costly and available only in specialized medical centers.
A new study co-authored by Yiwen Dong, assistant professor in Industrial and Enterprise Systems Engineering at The Grainger College of Engineering, offers a promising alternative. The research team developed and validated the Clinical Gait Evaluation with Neuromuscular Impairments (Clinical GENI), a low-cost, video-based method that allows clinicians to identify gait abnormalities and their contributing neuromuscular impairments in children with spastic CP.
Published in Frontiers in Human Neuroscience, the study found that Clinical GENI’s observational approach achieved strong agreement (83–100%) with 3D gait analysis. By using simple video recordings, clinicians can reliably evaluate gait and connect visible abnormalities to the neuromuscular impairments driving them.
“Traditional gait evaluation often overlooks the underlying neuromuscular impairments that cause abnormal walking patterns, which can lead to suboptimal treatment strategies,” said Dong. “Clinical GENI closes this gap by bridging the cause and effect through a GENI checklist, allowing clinicians to link the observed gait with the underlying neuromuscular impairments for better decision-making.”
The research also points to muscle weakness as the most common driver of gait issues—shifting attention away from spasticity, which has historically been emphasized in treatment. “Current treatment for spastic CP emphasizes mitigation of spasticity, but evidence has shown that surgical interventions targeting spasticity may have suboptimal improvements on gait, as they may weaken the muscle,” Dong explained. “The discovery of muscle weakness suggests that the interplay between various neuromuscular impairments needs to be taken into account when making surgical recommendations.”
Looking ahead, Dong envisions Clinical GENI evolving into a digital platform that integrates with patient-facing health technologies. “This tool can be transformed into a digital software that supports quantitative, evidence-based gait evaluation informed by neuromuscular impairments,” she said. “Future work will explore causal reasoning to guide more targeted interventions, with the potential to integrate with large language models to offer easy-to-understand gait interpretations for patients. Ultimately, we see Clinical GENI being integrated with systems like Epic and MyChart to guide better treatments for children with spastic CP.”
By lowering the barriers to gait evaluation, Clinical GENI expands access to meaningful assessment in clinical settings where advanced technology may not be available. It represents a step toward more equitable care and more efficient treatment planning for children with CP.
Yiwen Dong is an Illinois Grainger Engineering assistant professor in the Department of Industrial and Enterprise Systems Engineering with affiliations in the Department of Electrical and Computer Engineering and the Department of Civil and Environmental Engineering
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