Gait & posture最新文献

{"title":"The effect of script-driven emotional imagery on postural control in healthy individuals.","authors":"Sofie Van Wesemael, Elke Vlemincx, Nina Goossens, Remco Baggen, Sim Klaps, Katleen Bogaerts, Lotte Janssens","doi":"10.1016/j.gaitpost.2025.08.076","DOIUrl":"https://doi.org/10.1016/j.gaitpost.2025.08.076","url":null,"abstract":"<p><strong>Objective: </strong>Although emotions and postural control are strongly intertwined, more research is necessary to understand this intricate relationship. Therefore, we examined the effect of script-driven emotional imagery on postural control in healthy individuals.</p><p><strong>Methods: </strong>Forty-four healthy participants (50 % female, median age=27) imagined three emotional imagery scripts (hostile, acceptance, relaxation) in upright standing without visual input while center of pressure (CoP) was measured (mean sway, sway velocity, , and standard deviation in antero-posterior and medio-lateral directions, and sway path and area). After each script, valence, arousal, and dominance were rated with the Self-Assessment Manikin (SAM) to check whether emotion induction was successful. Effects of emotional imagery on CoP and SAM were analyzed through mixed models.</p><p><strong>Results: </strong>Emotions were successfully induced; participants felt less pleasant (p < 0.0001), more aroused (p < 0.0001), and less in control (p < 0.0001) during hostile compared to acceptance and relaxation scripts. Inducing emotions did not affect CoP (p > 0.05), with the exception of antero-posterior CoP sway, which was significantly smaller during relaxation compared to acceptance scripts (p = 0.04).</p><p><strong>Conclusion: </strong>Although emotions were successfully induced, they minimally affected postural control in healthy individuals.</p><p><strong>Significance: </strong>These findings suggest that healthy individuals may adopt flexible postural compensation strategies to successfully adjust for emotion-induced perturbations.</p>","PeriodicalId":94018,"journal":{"name":"Gait & posture","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145002269","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Age is just a number: Clustering gait and functional measures.","authors":"Matthew Jd Taylor, Marnee J McKay, Joshua Burns, Jennifer Baldwin, Aleksandra V Birn-Jeffery","doi":"10.1016/j.gaitpost.2025.08.080","DOIUrl":"https://doi.org/10.1016/j.gaitpost.2025.08.080","url":null,"abstract":"<p><strong>Objective: </strong>As we age, we walk slower, but it remains unclear whether this is consistent at an individual level. Current clinical assessment of function assumes movement deficits with older age, and clinical norms are linked to decades or specific age stratifications such as \"old\" or \"oldest-old\". Current approaches stratifying by age may hide trends of higher and lower functioning individuals within each age bracket. Therefore, our aim was to cluster spatiotemporal data, from the 1000 Norms Project, to understand if patterns of function could be identified without using age as a factor.</p><p><strong>Methods: </strong>The 1000 Norms Project, a cross-sectional, observational study, collected gait, functional performance, and self-reported health data (participants (n = 695) aged 18-92 years). Spatiotemporal and functional data were clustered, after rendering the parameters dimensionless.</p><p><strong>Results: </strong>Three clusters were identified (n = 277, 208, 210). Although age significantly differed between clusters, each showed a broad range (e.g. 20-92 years). Additionally, walking speed (Froude number) did not differ between clusters, often used to separate by age. Our clusters defined 3 groups, 'higher functioning', 'age average' and 'cautious gait', whose spatiotemporal, functional performance, strength and quality of life measures vastly differed, independent of walking speed and including a wide range of ages.</p><p><strong>Conclusion: </strong>Our analysis suggests that age should not be used to separate individuals into groups, and that our assumption of \"age matters\" may not be relevant when determining true functional movement ability. Further work is needed to understand normal senescence, true negative loss, and reversible loss within these functionally different groups.</p>","PeriodicalId":94018,"journal":{"name":"Gait & posture","volume":" ","pages":"109962"},"PeriodicalIF":2.4,"publicationDate":"2025-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145103236","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing postural balance control in young dinghy sailors pre, during and post training sessions.","authors":"Attilio Carraro, Alice Montelaghi, Marta Duina, Roberto Roklicer","doi":"10.1016/j.gaitpost.2025.08.083","DOIUrl":"https://doi.org/10.1016/j.gaitpost.2025.08.083","url":null,"abstract":"<p><strong>Objective: </strong>This study examined the acute effect of training on postural balance among young dinghy sailors. By measuring sway path and sway area of the center of pressure (CoP), the objective was to investigate whether training sessions on dinghy sailboat influence sway path and sway area measurements.</p><p><strong>Methods: </strong>Twelve competitive sailors (Optimist and Laser Radial class) performed a set of balance tests on both stable and unstable surfaces, with open and closed eyes, measured over three days. The first day served to familiarize the participants with the protocol. On the second and third days, CoP sway path and sway areas were assessed before, during and after the training session using a Wii Balance Board (WBB).</p><p><strong>Results: </strong>A general improvement in balance control was observed in most of the measured parameters. Statistical analysis (RM ANOVA) revealed significant reductions in sway path and sway area with closed eyes on an unstable surface comparing pre-, during- and post- measurement on the second day (p < 0.05), and for sway path with open and closed eyes on an unstable surface on the third day (p < 0.05).</p><p><strong>Conclusion: </strong>Findings of the present study show a short-term effect of sailing sessions on balance, suggesting that a single training session can induce acute improvements in postural control among young athletes. It is possible that the observed acute improvements are associated with immediate neuromuscular adaptation following sailing activity, specifically due to the unpredictable and dynamic environment in which sailing takes place. However, the temporal duration of this effect appears to be limited. As balance is an essential skill in sailing performance, future studies should investigate long-term effects and retention of training-induced improvements in postural control.</p>","PeriodicalId":94018,"journal":{"name":"Gait & posture","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145002206","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Experimental insights into muscle and joint roles in stumble recovery: A scoping review.","authors":"Oğuz Faik Seven, Metin Bicer, Mehmet Arif Adli","doi":"10.1016/j.gaitpost.2025.08.081","DOIUrl":"https://doi.org/10.1016/j.gaitpost.2025.08.081","url":null,"abstract":"<p><strong>Introduction: </strong>A major concern, often resulting in serious injuries and loss of independence, is caused by falls due to stumbling. Previous works, investigating stumble recovery responses isolated to joint or muscle responses, lacks a comprehensive view of coordinated whole-body recovery.</p><p><strong>Methods: </strong>A scoping review, on Web of Science, Scopus and PubMed, was conducted using keywords related to recovery from anteriorly-directed stumbles induced by physical obstruction of the swing limb during healthy human walking. Extracted data were experimental cohort, swing phase during stumble, perturbation apparatus, recovery strategies, biomechanical responses including joint kinematics, kinetics and muscle activity. A narrative synthesis was provided to summarize findings across studies.</p><p><strong>Results: </strong>23 of 337 identified studies met inclusion criteria. Limited focus on older adults or comparing them to young adults were found. Rigid and stationary obstacles were commonly used, while compliant/movable obstacles were rarely examined, limiting ecological validity. Recovery strategies varied by perturbation timing: foot elevation and lowering in early/mid-swing and late swing stumbles, respectively. Rare responses like delayed lowering and reaching were underexplored. Sagittal plane lower-limb kinematics were frequently reported, with often missing trunk motion, joint moments and EMG from proximal muscles.</p><p><strong>Conclusion: </strong>This review highlights the importance of rapid and coordinated whole-body responses in stumble recovery, particularly involving the support limb and trunk. Findings suggest rehabilitation should target hip extensor strength, trunk control and support limb engagement to improve recovery. Future research should investigate underexplored strategies, trunk and upper-limb involvement and age-related adaptations to enhance intervention design.</p>","PeriodicalId":94018,"journal":{"name":"Gait & posture","volume":" ","pages":"109963"},"PeriodicalIF":2.4,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145077040","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multi-segment models for kinetic analysis of women during pregnancy: A systematic review.","authors":"Jie Chen, Xin Li, Patria A Hume, Hannah Wyatt, Julie Choisne","doi":"10.1016/j.gaitpost.2025.08.082","DOIUrl":"https://doi.org/10.1016/j.gaitpost.2025.08.082","url":null,"abstract":"<p><strong>Background: </strong>During pregnancy, significant physiological, morphological, and hormonal changes profoundly affect women's biomechanics, increasing the risk of falls and musculoskeletal complaints, especially in the third trimester. To understand movement adaptations and musculoskeletal disorders in pregnant women, kinetic analysis using pregnant-specific multi-segment or musculoskeletal models is essential. This review aims to evaluate the development, applications and limitations of such models intended for kinetic analysis in pregnancy.</p><p><strong>Methods: </strong>Following the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement, PubMed, Web of Science, Scopus, and IEEE Xplore databases were searched systematically for kinetic studies involving the pregnant-specific multi-segment models. Quality assessment was completed to assess the methodological quality of the selected studies.</p><p><strong>Results: </strong>A total of 14 different pregnant-specific multi-segment models (including musculoskeletal models) used within 19 kinetic studies were included in this review. Currently, most scaling methods are marker-based and limited by pregnancy-related soft tissue artifacts. Segment inertial parameter estimations were largely based on regression models, which may not adequately capture the high degree of individual variability among pregnant women. Most existing models focus on analyzing lower-limb or lumbar kinetics during daily activities, yet many remain unvalidated and lack detailed lumbopelvic representations. Pregnant-specific musculoskeletal models are scarce and primarily rely on static optimization for lumbar muscle force estimation, which overlooks trunk co-contraction.</p><p><strong>Conclusion: </strong>Future research should focus on developing more detailed and validated pregnant-specific models, alongside advanced workflows for more accurate model personalization, to more accurately capture the biomechanical changes across different pregnancy stages and support clinically relevant kinetic analysis.</p>","PeriodicalId":94018,"journal":{"name":"Gait & posture","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145008611","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations between weight-bearing asymmetry and demographic factors during quiet standing in individuals with unilateral transfemoral amputation.","authors":"Ryota Morishima, Takeshi Hara, Yukihiko Mizuno, Genki Hisano, Hélène Pillet, Toshiki Kobayashi, Hiroaki Hobara","doi":"10.1016/j.gaitpost.2025.08.077","DOIUrl":"https://doi.org/10.1016/j.gaitpost.2025.08.077","url":null,"abstract":"<p><strong>Background: </strong>Individuals with unilateral transfemoral amputation (uTFA) are at increased risk of secondary musculoskeletal conditions due to excessive loading on the intact limb during functional activities. However, limited evidence exists regarding weight-bearing asymmetry during quiet standing in this population.</p><p><strong>Research question: </strong>Is weight-bearing asymmetry during quiet standing associated with demographic characteristics in physically active individuals with uTFA?</p><p><strong>Methods: </strong>Thirty-four individuals with uTFA were recruited. Participants stood naturally with each foot on a separate force platform while vertical ground reaction forces were recorded over 5 s. The weight-bearing ratio (WBR) was calculated as the ratio of load on the intact limb to that on the prosthetic limb. Correlation analyses assessed associations between WBR and age, height, body mass, and time since amputation (TSAmp). Group comparisons were conducted based on sex, residual limb length, prosthetic knee type (microprocessor vs. non-microprocessor), and athletic proficiency (Paralympian vs. non-Paralympian).</p><p><strong>Results: </strong>No significant correlations were found between WBR and demographic variables, sex, residual limb length or prosthetic knee type. However, Paralympians exhibited significantly more symmetrical weight-bearing than non-Paralympians.</p><p><strong>Significance: </strong>These findings indicate that athletic proficiency may be associated with more symmetrical weight-bearing during quiet standing in individuals with uTFA. However, the underlying mechanisms remain unclear, and further research is needed to confirm these observations and explore the role of sports participation in postural balance and asymmetry-related outcomes.</p>","PeriodicalId":94018,"journal":{"name":"Gait & posture","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144994725","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From resting-state to movement: The role of cortical networks in parkinsonian gait.","authors":"Layla Cupertino, Ellen Lirani-Silva, Diego Orcioli-Silva, Victor S Beretta, Lucas G S França, Daniel Boari Coelho, Rodrigo Vitorio","doi":"10.1016/j.gaitpost.2025.08.079","DOIUrl":"https://doi.org/10.1016/j.gaitpost.2025.08.079","url":null,"abstract":"<p><strong>Background: </strong>Gait impairments in Parkinson's disease (PD) arise from disruptions in automatic motor control, requiring compensatory engagement of cortical networks. This study compared resting-state functional connectivity in specific cortical regions (frontal, central, parietal, occipital, and temporal) between people with PD and healthy individuals and explored its potential association with multidimensional gait domains.</p><p><strong>Methods: </strong>Twenty individuals with PD and 19 healthy controls participated. Resting-state electroencephalography was recorded, and functional connectivity was analyzed using local efficiency measures. Spatiotemporal gait parameters were assessed to calculate scores for five gait domains. Spearman correlations were used to evaluate the association between regional connectivity and gait domains.</p><p><strong>Results: </strong>Individuals with PD exhibited reduced functional connectivity in frontal and central regions compared to healthy controls. Connectivity in the frontal region significantly correlated with the pace domain in PD, highlighting its role in compensatory mechanisms for maintaining gait speed. In healthy controls, broader correlations were observed: parietal and occipital connectivity were associated with pace and rhythm, suggesting more integrated and adaptive network functionality.</p><p><strong>Conclusion: </strong>Current findings highlight the distinct roles of cortical regions in regulating gait domains and the compensatory mechanisms employed in PD. The findings underscore the potential role of connectivity-based biomarkers in improving our understanding of gait impairments and informing targeted interventions, such as neuromodulation and rehabilitation. However, their clinical utility remains limited by methodological and feasibility challenges, and future research should focus on validating their applicability in larger, longitudinal, and task-based studies.</p>","PeriodicalId":94018,"journal":{"name":"Gait & posture","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144994699","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effects of cognitive demand on distributions of medial and lateral plantar loads while walking in anxiety-inducing virtual settings.","authors":"Kelly Poretti, Nicole E-P Stark, Peter C Fino, Tiphanie E Raffegeau","doi":"10.1016/j.gaitpost.2025.08.072","DOIUrl":"https://doi.org/10.1016/j.gaitpost.2025.08.072","url":null,"abstract":"<p><strong>Introduction: </strong>Both fall-related anxiety and cognitive demands affect balance and gait without additional motor complexity. High elevation settings in virtual reality elicit 'stiffening of posture' (i.e. reduced sway) and gait (i.e. slower gait speeds) that may influence locomotor balance. The purpose of this exploratory analysis was to examine locomotor balance control during a dual-task (DT), extemporaneous speech, and in anxiety-inducing settings. We predicted cognitive demand and fall-related anxiety would affect mediolateral locomotor balance, indicated by the difference between medial and lateral plantar loads.</p><p><strong>Methods: </strong>Participants were pseudorandomized into single-task (ST) or DT blocks first but always walked in low before high elevation virtual environment. Participants walked on a wooden walkway at a self-selected pace in virtual settings for one minute while wearing a head-mounted display (HTC Vive, version 2.0) and in-shoe load sensors (Loadsol Pro, novel). For the DT, participants concurrently spoke extemporaneously about a randomly assigned topic. Locomotor balance was examined using the distribution between the medial and lateral plantar loads across normalized stance. Statistical parametric mapping determined significant differences in medial and lateral plantar load distributions between walking conditions.</p><p><strong>Results: </strong>Insoles were fitted onto participants (N = 8, five women, height = 1.7 (0.1) meters, weight = 71.8 (11.5) kilograms). The SPM two-dimensional repeated measures ANOVA found a region of difference for the main effect of height from 33 % to 35.5 % of stance (p = .033). The medial and lateral plantar load distribution was decreased representing a more medial position of the center of pressure (COP) at approximately 34 % of the stance phase walking at high VR height compared to low VR height.</p><p><strong>Significance: </strong>Walking in anxiety-inducing settings , but not umder cognitive demand, was associated with a more medial position of the COP at 34 % of stance, suggesting a dynamic spatially-based balance response to laterally-oriented postural threats during the early stance phase of a step.</p>","PeriodicalId":94018,"journal":{"name":"Gait & posture","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144994855","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Discrepancies between clinical assessments of lower limb torsional deformities and gait kinematics in ambulatory individuals with cerebral palsy.","authors":"Brian Po-Jung Chen, Chao-Jan Wang, Chia-Ling Chen, Chia-Hsieh Chang","doi":"10.1016/j.gaitpost.2025.08.070","DOIUrl":"https://doi.org/10.1016/j.gaitpost.2025.08.070","url":null,"abstract":"<p><strong>Background: </strong>Cerebral palsy (CP) often presents with lower limb torsional deformities that affect gait and mobility. Clinical assessments typically rely on static physical examinations, but discrepancies arise when compared with dynamic gait kinematics. Understanding the relationship between clinical assessments, including imaging, and gait analysis is essential for accurate diagnosis and treatment planning.</p><p><strong>Methods: </strong>This cross-sectional study included 106 limbs from 53 ambulatory individuals with CP, classified as GMFCS levels I to III. Participants underwent standardized physical examinations to assess lower limb rotational deformities, along with three-dimensional CT imaging to quantify skeletal torsion. Instrumented gait analysis measured the foot progression angle (FPA) at angle at initial contact, foot off, and terminal swing. Linear regression analyses examined correlations among these measures, with subgroup analyses by GMFCS level.</p><p><strong>Results: </strong>Weak correlations were observed between physical examination findings and gait kinematics (R² < 0.5000). Imaging, particularly tibial torsion, showed stronger associations with FPA, especially in GMFCS levels I and III (R² up to 0.9112). GMFCS level II participants showed weaker correlations, suggesting different compensatory mechanisms. Functional severity influenced how static assessments aligned with dynamic gait parameters.</p><p><strong>Conclusion: </strong>While CT remains the gold standard for skeletal torsional deformities, static measurements do not necessarily reflect dynamic gait function. Gait is not solely dictated by skeletal alignment but also shaped by compensatory neuromotor strategies. Integrating gait analysis and imaging into clinical decision-making may improve surgical planning and outcomes, especially when stratified by GMFCS levels.</p>","PeriodicalId":94018,"journal":{"name":"Gait & posture","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144994710","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"BEST PAPER Gait and Clinical Motion Analysis Society meeting 2024: The prevalence and risk factors associated with anterior pelvic tilt in ambulatory youth with cerebral palsy.","authors":"Chris Church, Nancy Lennon, Jose Salazar-Torres, Thomas Shields, Tanmayee Joshi, John Henley, Freeman Miller, M Wade Shrader, Jason J Howard","doi":"10.1016/j.gaitpost.2025.01.033","DOIUrl":"https://doi.org/10.1016/j.gaitpost.2025.01.033","url":null,"abstract":"<p><strong>Background: </strong>Excessive anterior pelvic tilt (APT) in youth with cerebral palsy (CP) may be associated with back pain and functional limitations. This study aimed to determine risk factors for excessive APT and significant change during childhood in ambulatory youth with CP.</p><p><strong>Methods: </strong>This institutional review board-approved retrospective study identified youth with bilateral spastic CP and multiple gait analyses. Pairs of gait analyses were used to measure change in pelvic tilt. A mixed effects linear regression analysis predicted patient and surgical factors associated with change in pelvic tilt. A logistic mixed effects generalized linear regression identified factors associated with an increase in anterior pelvic tilt.</p><p><strong>Results: </strong>Meeting inclusion criteria were 503 youth [female: 207/male: 297; Gross Motor Function Classification System I (n = 50), II (n = 328), and III (n = 125)]. Pairs of gait analyses (n = 632) were analyzed: age 11 ± 4 y at visit 1 and 13 ± 6 y at visit 2. Five hundred twenty-six pairs of gait analyses had intervening surgery; 106 had no surgery. Pelvic tilt was 20 ± 9° anterior at visit 2 in both the surgery and no surgery groups (p = 0.63). Prior selective dorsal rhizotomy, older age, and medial+lateral hamstring lengthening (HL) were significant factors associated with increases in APT; Achilles lengthening, higher gross motor function score, and high APT at visit 1 were protective. The mean change in pelvic tilt after medial only vs medial+lateral HL was 1 ± 9° (p = 0.046) and 4 ± 9° (p < 0.0001), respectively.</p><p><strong>Significance: </strong>Risk factors associated with increased APT for youth with CP were multifactorial, with prior selective dorsal rhizotomy and high-dose HL having the most significant negative effects. Contrary to conventional thinking, high initial APT was not associated with further progression. Risk factors for progression of APT should be considered when developing a surgical plan, particularly for youth with a normal or posteriorly tilted pelvis, given the susceptibility to more change in pelvic tilt.</p><p><strong>Level of evidence: </strong>Level III.</p>","PeriodicalId":94018,"journal":{"name":"Gait & posture","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588965","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}