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Muscle strength and kinetic gait pattern in children with bilateral spastic CP
Meta Nyström Eek1, Roy Tranberg, Eva Beckung
1Queen Silvia Childrens Hospital, Department of Paediatrics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden. meta.nystrom-eek@vgregion.se
Insights
Children with cerebral palsy (CP) exhibit weaker leg muscles and altered gait, with ankle moments closely related to their reduced muscle strength. This highlights the importance of overall lower extremity strength in CP gait patterns.
Area of Science:
- Biomechanics
- Neurology
- Pediatrics
Background:
- Cerebral palsy (CP) frequently results in abnormal gait patterns.
- Understanding the relationship between muscle strength and gait kinetics is crucial for effective interventions in children with CP.
Purpose of the Study:
- To investigate the correlation between muscle strength and kinetic gait parameters in children with bilateral spastic cerebral palsy (CP).
- To compare gait patterns and muscle strength between children with CP and typically developing children.
Main Methods:
- Muscle strength was measured in eight lower extremity muscle groups for 20 children with CP and 20 typically developing children.
- A 3-dimensional gait analysis, including force data, was performed on all participants.
Main Results:
- Children with CP demonstrated significantly lower muscle strength across all measured groups compared to controls.
- CP group exhibited slower walking velocity, shorter stride length, and reduced ankle gait moments.
- Gait moments in children with CP were closer to their maximal muscle strength, with significant correlations found between plantarflexing gait moment, muscle strength, and ankle power generation.
Conclusions:
- Reduced overall lower extremity muscle strength is a key factor in the altered gait patterns observed in children with CP.
- The findings emphasize the critical role of plantarflexor muscle strength and its relationship with gait moments and power generation in CP.
- Interventions should consider the comprehensive muscle strength profile of the lower extremities in children with CP.
Abstract:
Cerebral palsy is often associated with an abnormal gait pattern. This study put focus on relation between muscle strength and kinetic gait pattern in children with bilateral spastic cerebral palsy and compares them with a reference group. In total 20 children with CP and 20 typically developing children participated. They were all assessed with measurement of muscle strength in eight muscle groups in the legs and a 3-dimensional gait analysis including force data. It was found that children with CP were not only significantly weaker in all muscle groups but also walked with slower velocity and shorter stride length when compared with the reference group. Gait moments differed at the ankle level with significantly lower moments in children with CP. Gait moments were closer to the maximal muscle strength in the group of children with CP. Furthermore a correlation between plantarflexing gait moment and muscle strength was observed in six of the eight muscle groups in children with CP, a relation not found in the reference group. A similar pattern was seen between muscle strength and generating ankle power with a rho=0.582-0.766. The results of this study state the importance of the relationship of the overall muscle strength pattern in the lower extremity, not only the plantarflexors.
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