Gait pattern differences in children with unilateral cerebral palsy
Andrzej Szopa1, Małgorzata Domagalska-Szopa1, Andrzej Czamara2
1School of Health Sciences, Medical University of Silesia, Medyków 12, Katowice 40-752, Poland.
Insights
Children with cerebral palsy exhibit distinct gait patterns based on how they distribute weight. The anti-gravitational gait pattern shows greater deviation from normal walking compared to the pro-gravitational gait pattern.
Area of Science:
- Neurology
- Biomechanics
- Pediatrics
Background:
- Children with cerebral palsy (CP) often display atypical posture and gait due to central nervous system damage.
- Previous research identified two distinct postural patterns in unilateral CP: affected side overloading and under-loading.
- Functional strategies are employed by children with CP to compensate for primary neurological anomalies.
Purpose of the Study:
- To investigate if different gait patterns correlate with weight distribution between affected and unaffected sides in children with unilateral CP.
- To identify and classify gait patterns in children with unilateral CP based on weight-bearing strategies.
- To compare gait deviations between identified patterns and a reference group.
Main Methods:
- Included 45 outpatients with unilateral CP and 51 children with mild scoliosis (reference group).
- Employed paedobarographic measurements to assess body mass distribution.
- Utilized 3D instrumented gait analysis and cluster analysis based on Gillette Gait Index (GGI) values.
Main Results:
- Three distinct gait patterns were identified: scoliotic gait, pro-gravitational gait pattern (PGP - affected side overloading), and anti-gravitational gait pattern (AGP - affected side under-loading).
- Subjects with AGP demonstrated a significantly higher degree of deviation from normal gait compared to those with PGP.
- Significant differences in GGI were found between AGP and PGP.
Conclusions:
- Distinct gait patterns (PGP and AGP) exist in children with unilateral CP, linked to weight distribution strategies.
- The anti-gravitational gait pattern (AGP) is associated with more pronounced gait abnormalities than the pro-gravitational gait pattern (PGP).
- These findings provide a basis for future studies exploring kinematic differences between these identified gait patterns in CP.
Abstract:
Children with cerebral palsy (CP) often have atypical body posture patterns and abnormal gait patterns resulting from functional strategies to compensate for primary anomalies that are directly attributable to damage to the central nervous system. Our previous study revealed two different postural patterns in children with unilateral CP: (1) a pattern with overloading of the affected body side and (2) a pattern with under-loading of the affected side. The purpose of present study was to test whether different gait patterns dependent on weight distribution between the affected and unaffected body sides could be detected in these children. The study included 45 outpatients with unilateral CP and 51 children with mild scoliosis (reference group). The examination consisted of two inter-related parts: paedobarographic measurements of the body mass distribution between the body sides and three-dimensional instrumented gait analysis. Using cluster analysis based on the Gillette Gait Index (GGI) values, three gait patterns were described: a scoliotic gait pattern and two hemiplegic gait patterns, corresponding to overloading/under-loading of the hemi-side, which are the pro-gravitational gait pattern (PGP) and the anti-gravitational gait pattern (AGP), respectively. The results of this study showed that subjects with AGP presented a higher degree of deviation from the normal gait than children with PGP. This proof that there are differences in the GGI between the AGP and PGP could be a starting point to identify kinematic differences between these gaits in a follow-up study.
