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Arm swing during walking at different speeds in children with Cerebral Palsy and typically developing children
Pieter Meyns1, Leen Van Gestel, Firas Massaad
1Department of Biomedical Kinesiology, Faculty of Kinesiology and Rehabilitation Sciences, K.U.Leuven, Heverlee, Belgium. Pieter.meyns@faber.kuleuven
Insights
Children with cerebral palsy (CP) use arm swings differently when walking. Arm movements are crucial for gait training in both diplegia and hemiplegia, aiding speed and compensation.
Area of Science:
- Biomedical Engineering
- Neuroscience
- Pediatrics
Background:
- Children with Cerebral Palsy (CP) often exhibit impaired walking, particularly at higher speeds.
- Arm movements are recognized as essential for achieving faster walking speeds in typically developing individuals.
- The specific role of arm movements during varying walking speeds in children with CP remains under-investigated.
Purpose of the Study:
- To investigate the utilization of arm movements at preferred and maximal walking speeds in children with diplegia (DI) and hemiplegia (HE).
- To compare arm and leg swing kinematics between children with CP (DI and HE) and typically developing (TD) children.
- To understand how arm swing adaptations differ between CP subtypes and TD children across different walking speeds.
Main Methods:
- 3D gait analysis was employed to measure arm and leg swing lengths.
- Participants included 11 children with hemiplegia (HE), 15 with diplegia (DI), and 24 typically developing (TD) children.
- Gait analysis was performed at both preferred and "as fast as possible" walking speeds.
Main Results:
- Typically developing children demonstrated a greater increase in walking speed compared to both CP groups.
- Hemiplegic children exhibited larger arm swings on the non-hemiplegic side versus the hemiplegic side, without speed-dependent increases.
- Diplegic children showed reduced leg swing lengths at both walking speeds.
- Hemiplegic children's leg swing was larger on the non-hemiplegic side only at preferred speeds.
Conclusions:
- Arm swing plays a significant role in gait for both DI and HE children, serving different functional purposes.
- For DI children, arm swing appears to contribute to increasing walking speed.
- For HE children, arm swing may compensate for reduced movement on the affected side.
- Encouraging arm movements in gait training, such as treadmill training, is recommended for children with CP.
Abstract:
Children with Cerebral Palsy (CP) have difficulties walking at a normal or high speed. It is known that arm movements play an important role to achieve higher walking speeds in healthy subjects. However, the role played by arm movements while walking at different speeds has received no attention in children with CP. Therefore we investigated the use of arm movements at two walking speeds for children with diplegia (DI) and hemiplegia (HE) as compared to typically developing (TD) children. Arm and leg swing lengths were determined in 11 HE children and 15 DI children and compared to 24 TD children using 3D gait analysis at their preferred and "as fast as possible" walking speeds. We found that TD children increased walking speed more than both CP groups. HE children showed larger arm swings on the non-hemiplegic compared to the hemiplegic side for both walking speeds. In contrast to TD or DI children, the HE group did not show an increase in arm swing length with increasing walking speed. Their leg swing length was larger on the non-hemiplegic than on the hemiplegic side but only at the preferred walking speed. The DI children exhibited smaller leg swings at both walking speeds. Since arm swing is used both by DI (to increase speed) and by HE children (to compensate for the reduced movement on the affected side) it is argued that these movements are important and should be allowed (or even encouraged) in gait training procedures (such as treadmill training).
