• change in each of these measures, from baseline to 12 months:
• Pediatric Outcomes Data Collection Instrument(PODCI)
• the Gillette Functional Assessment Questionnaire (FAQ)
• the Functional Mobility Scale (FMS)
• the Activity Scale for Kids (ASK)
• the Normalcy Index (quantifies the magnitude of gait deviation from normal)
• O2 consumption and O2 Cost during walking
• Gait velocity
• Stride length

The purpose of this pilot trial is to determine whether the addition of gait laboratory analysis for surgical decision making, compared with the use of observational analysis alone, results in improved functional outcomes in ambulatory children with cerebral palsy undergoing multi-level lower extremity orthopaedic surgery.

Children with cerebral palsy, who are ambulatory, have an inefficient gait often associated with functional disability. Many of these children are candidates for orthopaedic surgery, which includes multi-level soft tissue and bony procedures. Pre-operative planning is based on the physical examination and visual (observational) analysis of the child’s gait. In some centres, patients undergo additional gait analysis in a motion laboratory. While gait laboratory analysis is accepted as an important research tool, there is controversy about its clinical utility in decision making for the surgical management of this population. To date, no clinical trials have been undertaken to answer this question, and the appropriate clinical utilization of this technology is yet to be established. The consequence of this uncertainty is that ambulatory children with cerebral palsy are either being deprived of a useful assessment tool in some centres, or alternatively they are being subjected to an unnecessary evaluation that is both expensive and time consuming in other centres. This pilot trial will assess the feasibility of a larger trial to determine whether the addition of gait laboratory analysis for surgical decision making, compared with the use of observational analysis alone, results in improved functional outcomes in ambulatory children with cerebral palsy undergoing multi-level lower extremity orthopaedic surgery.

Inclusion Criteria:

• Ambulatory children with a diagnosis of spastic cerebral palsy
• Candidates for multi-level lower extremity orthopaedic procedures including soft tissue and/or bony procedures involving at least 2 levels, in one or both lower extremities

Exclusion Criteria:

• Dystonia
• Athetosis
• Mixed tone abnormalities
• A history of orthopaedic procedures within the previous 2 years
• Had previous gait analysis