Gait characteristics in children and adolescents with cerebral palsy and typically developing peers
MetadataVis full innførsel
Background: Children with cerebral palsy (CP) have varying levels of deficits in bodily movement that can lead to slower and less stable gait compared to typically developing peers (TD). 3D gait analysis is used to investigate impaired gait. However, it is debated whether this test is representative of daily life walking. Body worn accelerometers can detect some gait characteristics, and because they are portable and lightweight, they can also assess gait in an out-of-lab setting. Aim: The overall purpose was to investigate gait characteristics in children and adolescents with CP and TD, using accelerometry. The aim was two-fold; 1) to compare gait parameters between short distance walking in a lab and longer distance walking out-of-lab (field), in a CP and TD group, walking at preferred and fast speed, and 2) to compare gait parameters between CP and TD when walking in lab and out-of-lab at both preferred and fast speed. Methods: 22 children participated; 7 with CP (6-16 yrs.) and 15 TD (6-14 yrs.). Participants conducted walking tests in two settings, while an accelerometer placed on the back measured all movement; 1) a 5-minute walk test at preferred gait speed (PW-field), and a 1-minute walk test at fast gait speed (FW-field) were conducted in field, and 2) a 7-meter 3D gait analysis, at preferred (PW-lab) and fast gait speed (FW-lab) were conducted in a gait lab. Gait speed, step length and cadence, trunk acceleration (RMS) and jerk amplitude (JERK) were measured. Acceleration signal was converted to vertical (V), anteroposterior (AP) and mediolateral (ML) direction. Results: Difference in gait parameters between lab and field were not significant among CP participants (p>.05). TD participants had significant different speed (p=.009), RMS (p=.003) and JERK (p=.002) between field and lab. CP group had significant lower gait speed, relative step length, and cadence during PW-lab (p<.05) and FW-field (p<.05), compared to TD. RMS in V direction were lower in CP compared to TD in PW-lab (p=.044) and FW-lab (p=.035) and JERK in AP direction in FW-field (p=.023). Conclusion: Gait characteristics were different in lab and field for both CP and TD, which implies differences in short and structured walking tasks compared to longer distance walking. CP had lower gait parameters than TD in all walking tests, except for higher trunk accelerations in preferred field walking. This suggests that CP participants had a different gait strategy during longer distance walking compared to TD participants. A tendency for greater group difference with increased gait speed, indicates that CP participants did not have the same range in gait speed as TD participants.