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[Spasticity and dynamic plantar pressure distribution measurements in hemiplegic spastic children]
Insights
Spasticity in hemiplegic children alters foot-ground contact, affecting plantar pressure distribution. Higher spasticity leads to specific deformities and gait patterns, impacting stability during walking.
Area of Science:
- Biomechanics
- Neurology
- Pediatrics
Context:
- Cerebral palsy (CP) significantly impacts motor function, particularly in children.
- Spastic hemiplegia, a common form of CP, affects muscle tone and gait.
- Understanding plantar pressure is crucial for assessing gait abnormalities in CP.
Purpose:
- To analyze plantar pressure distribution in spastic hemiplegic children.
- To investigate the dynamic alterations during the stance phase of gait.
- To correlate plantar pressure with spasticity grade.
Summary:
- Plantar pressure distribution differs between healthy children and those with spastic hemiplegia.
- Higher peak pressures were observed under the midfoot in spastic groups compared to controls.
- Significant alterations in plantar pressure were noted under the forefoot and hallux, varying with spasticity levels.
Impact:
- Findings highlight how spasticity influences foot-ground interaction and gait patterns.
- Identifies specific plantar pressure profiles linked to spasticity severity.
- Informs potential therapeutic interventions for improving gait stability and function in children with hemiplegic spasticity.
Objective:
The aim of this study was to analyse the plantar pressure distribution in nine hemiplegic spastic children to illustrate the dynamic alteration during stance phase linked spasticity grade.
Material And Methods:
The graduation of the lower limbs muscle tone related to the Aschworth spasticity scale enabled us to identify two groups of hemiplegics subjects. The groups Asch 1 and Asch 3 have respectively presented a low and a strong spasticity. The peak pressures during consecutive gait cycles were determined under the feet of 30 healthy subjects and two cerebral palsy groups using a wearable footprint analysis system.
Results:
A statistical study showed a similarity between the two disabled groups. Peak pressures under the midfoot were significantly higher compared to the control group. While the plantar pressure distribution profile was specific for each group under all other anatomical structures. The significant alterations were observed under the forefoot and hallux.
Discussion-Conclusion:
Spasticity modifies the foot contact to ground and leads to a specific plantar pressure distribution profile linked to the spasticity grade. The equinovarus with clawed toes deformity due to higher spasticity seems to be an important factor in terminal stance phase perturbations. However spastic hemiplegic subjects seem to adopt a gait pattern in agreement with stability optimization criteria.