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Published on: August 23, 2017
Gait adaptation of children with cerebral palsy compared with control children when stepping over an obstacle
Louisa S H Law1, Cecilia Y Webb
1Department of Biobehavioural Sciences, Teachers College, Columbia University, NewYork, NY 10027, USA. rsllaw@inet.polyu.edu.hk
Insights
Children with spastic diplegic cerebral palsy (CP) adapt obstacle crossing by increasing foot clearance but show slower speeds and wider stances. Their motor control issues stem from torque dynamics, not movement matching.
Area of Science:
- Biomechanical analysis of human movement
- Pediatric motor control research
Background:
- Children with spastic diplegic cerebral palsy (CP) often exhibit altered gait patterns.
- Understanding adaptive strategies in obstacle clearance is crucial for improving mobility in children with CP.
Purpose of the Study:
- To investigate and compare the adaptive gait patterns during obstacle clearance between normally developing (ND) children and children with spastic diplegic cerebral palsy (CP).
- To identify the underlying motor control mechanisms affecting obstacle negotiation in children with CP.
Main Methods:
- Kinematic data of 3D leg movements were collected using the Vicon system for 12 ND children and 12 children with CP.
- Participants crossed obstacles of varying heights (0%, 10%, 20% leg length).
- Data were analyzed using one-way analysis of variance with repeated measures.
Main Results:
- Both groups increased foot clearance with higher obstacles.
- Children with CP demonstrated slower approach and crossing speeds.
- Children with CP adopted a wider base of support when obstacle height increased.
Conclusions:
- Children with CP exhibit distinct kinematic adjustments for obstacle clearance compared to ND peers.
- Motor control deficits in CP children appear related to implicit processes (torque dynamics) rather than explicit movement matching.
- These findings highlight potential targets for therapeutic interventions aimed at improving gait and mobility in children with CP.
Abstract:
This study investigated the adaptive gait pattern in obstacle clearance in 12 normally developing (ND) children (six males, six females; mean age 10y 2mo, SD 10mo) and 12 children who had spastic diplegic cerebral palsy (CP) and who were independent ambulators (10 males, two females; mean age 13y 5mo, SD 2y 7mo). Children in both groups had 8 to 12 years of walking experience. They walked up to and crossed over obstacles of a height of 0%, 10%, and 20% of their leg length. Kinematic aspects of the three-dimensional leg movements were captured with the Vicon system and analyzed with one-way analysis of variance with repeated measure. Both groups increased foot clearance for higher obstacles. Children with CP were slower in approach and crossing speed, and used a wider base of support than the ND children when the obstacle height was increased. Results suggest that motor problems in obstacle clearance in children with CP lie in the implicit process of motor control, i.e. torque dynamics, not the explicit process, i.e. movement-match with the environmental constraints.
