Is interlimb coordination during walking preserved in children with cerebral palsy?
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Updated: May 23, 2026
Event-related Potentials During Target-response Tasks to Study Cognitive Processes of Upper Limb Use in Children with Unilateral Cerebral Palsy
Published on: January 11, 2016
Pieter Meyns1, Leen Van Gestel, Sjoerd M Bruijn
1Department of Kinesiology, Faculty of Kinesiology and Rehabilitation Sciences, KU Leuven, Heverlee, Belgium. pieter.meyns@gmail.com
Insights
Children with cerebral palsy (CP) show altered arm movements affecting interlimb coordination during gait. Increased walking speed improved coordination in diplegic CP, highlighting the importance of arm swing for gait stability.
Area of Science:
- Biomedical Engineering
- Neuroscience
- Pediatric Rehabilitation
Background:
- Altered arm movements are characteristic of cerebral palsy (CP) gait.
- The impact of these arm movement changes on interlimb coordination in children with CP is not fully understood.
Purpose of the Study:
- To investigate how altered arm movements in children with cerebral palsy (CP) affect interlimb coordination during gait.
- To compare coordination patterns between children with diplegia (DI) and hemiplegia (HE) and typically developing (TD) children.
Main Methods:
- 3D gait analysis was conducted on children with CP (DI and HE) and TD children at preferred and fast walking speeds.
- Interlimb coordination was quantified using Mean Relative Phase (MRP) and the standard deviation of Continuous Relative Phase (CRP) to assess coordination and stability.
- Limb-leading patterns were identified by the sign of MRP.
Main Results:
- In hemiplegic (HE) CP, altered coordination and stability were observed when the affected arm was included in analysis, with a different leading limb compared to TD children.
- In diplegic (DI) CP, coordination significantly deteriorated when legs were involved, and coordinative stability was affected when arms were involved. Limb-leading patterns differed from TD children in most combinations.
- Increased walking speed improved coordination and stability in several limb pairs for DI children, with deficits often linked to the affected limb.
Conclusions:
- Cerebral palsy significantly alters interlimb coordination during gait, with specific deficits depending on the CP type (hemiplegia or diplegia).
- The affected arm plays a crucial role in coordination deficits in hemiplegia, while arm involvement impacts stability in diplegia.
- Increasing walking speed shows potential as an intervention to improve gait coordination in children with diplegic cerebral palsy.
Abstract:
Arm movements during gait in children with cerebral palsy (CP) are altered compared to typically developing children (TD). We investigated whether these changes in arm movements alter interlimb coordination in CP gait. 3D gait analysis was performed in CP (diplegia [DI]: N = 15 and hemiplegia [HE]: N = 11) and TD (N = 24) children at preferred and fast walking speeds. Mean Relative Phase (MRP, i.e. mean over the gait cycle of the Continuous Relative Phase or CRP) was calculated as a measure of coordination, standard deviation of CRP was used as a measure of coordinative stability, and the sign of MRP indicated which limb was leading (for all pair combinations of the four limbs). In HE, coordination was significantly altered, less stable and a different leading limb was found compared to TD whenever the most affected arm was included in the studied limb pair. In DI, coordination deteriorated significantly when any of the two legs was included in the studied limb pair, and coordinative stability was significantly affected when any of the two arms was included. In almost all limb pair combinations, a different limb was leading in DI compared to TD. Increasing walking speed significantly improved coordination and coordinative stability of several limb pairs in DI. Coordination and limb-leading deficits were mostly linked to the affected limb. The compensating (non-affected) arm primarily affected coordinative stability, which underlines the importance of active arm movements in HE. Increasing walking speed may be used to improve interlimb coordination in DI.
