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Index of mechanical work in gait of children with cerebral palsy
Alicja Katarzyna Dziuba1, Małgorzata Tylkowska1, Sebastian Jaroszczuk1
1University School of Physical Education, Aleje J.I. Paderewskiego 35, 51-612 Wrocław, Poland.
Insights
Children with cerebral palsy (CP) exhibit increased mechanical work during gait, directly correlating with walking speed and disability severity. This study establishes standards for mechanical work in CP gait, aiding diagnosis for healthcare professionals.
Area of Science:
- Biomechanics
- Pediatrics
- Rehabilitation Medicine
Background:
- Pathological gait in children with cerebral palsy (CP) is characterized by increased mechanical work, impacting societal function.
- Mechanical work during gait is closely linked to walking speed, yet its specific influence in CP populations requires further analysis.
Purpose of the Study:
- To establish normative standards for mechanical work during the gait of children with cerebral palsy, stratified by walking speed.
- To investigate the relationship between mechanical work, walking speed, and the degree of disability in children with CP.
Main Methods:
- Evaluated mechanical work, kinetic, potential, and rotational energy during gait in 18 children with CP and 14 healthy children.
- Utilized BTS Smart software and custom software for quantitative analysis of gait parameters.
- Correlated mechanical work with walking speed and assessed the contribution of different energy components.
Main Results:
- Mechanical work in children with CP significantly increases with the degree of disability and is linearly related to walking speed.
- A significant negative correlation exists between the degree of disability and walking speed in children with CP.
- Kinetic energy's contribution to total mechanical work increases with walking speed; foot mechanical energy is the primary contributor.
Conclusions:
- The developed method offers an objective tool for diagnosing gait in children with CP, assisting doctors and physical therapists.
- Understanding the relationship between mechanical work, speed, and disability provides valuable insights for therapeutic interventions.
- Gait analysis in CP can be enhanced by considering walking speed as a critical factor influencing mechanical work and energy expenditure.
Abstract:
The pathological gait of children with cerebral palsy involves higher mechanical work, which limits their ability to function properly in society. Mechanical work is directly related to walking speed and, although a number of studies have been carried out in this field, few of them analysed the effect of the speed. The study aimed to develop standards for mechanical work during gait of children with cerebral palsy depending on the walking speed. The study covered 18 children with cerebral palsy and 14 healthy children. The BTS Smart software and the author's software were used to evaluate mechanical work, kinetic, potential and rotational energy connected with motion of the children body during walk. Compared to healthy subjects, mechanical work in children with cerebral palsy increases with the degree of disability. It can be expressed as a linear function of walking speed and shows strong and statistically significant correlations with walking gait. A negative statistically significant correlation between the degree of disability and walking speed can be observed. The highest contribution to the total mechanical energy during gait is from mechanical energy of the feet. Instantaneous value of rotational energy is 700 times lower than the instantaneous mechanical energy. An increase in walking speed causes the increase in the effect of the index of kinetic energy on total mechanical work. The method described can provide an objective supplementation for doctors and physical therapists to perform a simple and immediate diagnosis without much technical knowledge.
