Gait stability in children with Cerebral Palsy
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Published on: August 30, 2016
Sjoerd M Bruijn1, Matthew Millard, Leen van Gestel
1Research Center for Movement Control and Neuroplasticity, Department of Kinesiology, KU Leuven, Belgium. s.m.bruijn@gmail.com
Insights
A new foot placement estimator (FPE) effectively measures gait stability in children with Cerebral Palsy (CP) and typically developing children. This tool accurately detects instabilities without needing extensive data, aiding in assessing gait in various populations.
Area of Science:
- Biomechanical analysis of human locomotion
- Pediatric motor control and rehabilitation
Background:
- Children with unilateral Cerebral Palsy (CP) often exhibit gait impairments, including reduced stability.
- Assessing gait stability is crucial for understanding functional limitations and guiding interventions in CP.
Purpose of the Study:
- To evaluate the efficacy of a novel foot placement estimator (FPE) for quantifying gait stability.
- To determine the FPE's sensitivity to calculation assumptions and its ability to differentiate between children with CP and typically developing (TD) children.
- To assess the FPE's responsiveness to variations in walking speed.
Main Methods:
- Gait kinematics were recorded for children with CP and TD children walking at two different speeds.
- The foot placement estimator (FPE) was calculated using the recorded gait data.
- The FPE's sensitivity to assumption violations and its ability to detect group and speed differences were analyzed.
Main Results:
- Children with CP demonstrated significant anterior-posterior and mediolateral gait instabilities.
- Errors in FPE calculation due to assumption violations were minimal (approximately 1.5 cm).
- Walking speed and group (CP vs. TD) had larger effects on FPE values than assumption violations.
Conclusions:
- The foot placement estimator (FPE) is a sensitive and reliable measure for quantifying gait stability in both typically developing children and those with Cerebral Palsy.
- The FPE's minimal sensitivity to assumption violations makes it a robust tool for clinical and research applications.
- This measure can effectively distinguish between the gait stability of children with CP and their typically developing peers.
Abstract:
Children with unilateral Cerebral Palsy (CP) have several gait impairments, amongst which impaired gait stability may be one. We tested whether a newly developed stability measure (the foot placement estimator, FPE) which does not require long data series, can be used to asses gait stability in typically developing (TD) children as well as children with CP. In doing so, we tested the FPE's sensitivity to the assumptions needed to calculate this measure, as well as the ability of the FPE to detect differences in stability between children with CP and TD children, and differences in walking speed. Participants were asked to walk at two different speeds, while gait kinematics were recorded. From these data, the FPE, as well as the error that violations of assumptions of the FPE could have caused were calculated. The results showed that children with CP walked with marked instabilities in anterior-posterior and mediolateral directions. Furthermore, errors caused by violations of assumptions in calculation of FPE were only small (≈ 1.5 cm), while effects of walking speed (≈ 20 cm per m/s increase in walking speed) and group (≈ 5 cm) were much larger. These results suggest that the FPE may be used to quantify gait stability in TD children and children with CP.
