Selective motor control correlates with gait abnormality in children with cerebral palsy
Emily Chruscikowski1, Nicola R D Fry2, Jonathan J Noble2
1One Small Step Gait Laboratory, Guy's and St. Thomas' NHS Foundation Trust, Lower ground, Southwark Wing, Guy's Hospital, Great Maze Pond, London, SE1 9RT, United Kingdom; Division of Imaging Sciences & Biomedical Engineering, 4th Floor, Lambeth Wing St. Thomas' Hospital, Westminster Bridge Road, London, SE1 7EH, United Kingdom; Department of Medical Engineering and Physics, King's College Hospital, Denmark Hill, London, SE5 9RS, United Kingdom.
Insights
Children with cerebral palsy (CP) often have limited selective motor control (SMC), impacting their walking ability. This study found that poorer SMC scores correlate with more severe gait impairments in children with CP.
Area of Science:
- Neurology
- Pediatrics
- Physical Therapy
Background:
- Children with bilateral cerebral palsy (CP) frequently experience limited selective motor control (SMC), affecting functional tasks.
- The precise impact of impaired SMC on the overall walking pattern in children with CP remains incompletely understood.
- While SMC measures correlate with specific gait characteristics, their effect on the general gait pattern is not well-reported.
Purpose of the Study:
- To investigate the relationship between selective motor control (SMC) and overall gait impairment in children with bilateral CP.
- To analyze SMC data collected during routine clinical gait analysis to understand its impact on walking patterns.
Main Methods:
- Utilized data from 194 children with bilateral CP undergoing clinical gait analysis at a single center.
- Measured SMC using the Selective Control Assessment of the Lower Extremities (SCALE) as part of their clinical assessment.
- Compared summed SCALE scores with overall gait impairment measured by the Gait Profile Score (GPS).
Main Results:
- A significant negative correlation was observed between SCALE scores and GPS (rs=-0.603, p<0.001).
- Lower scores on the SCALE assessment were associated with higher levels of overall gait impairment (higher GPS).
Conclusions:
- Damage to motor tracts responsible for SMC in CP is linked to altered development of walking patterns.
- Impaired selective motor control significantly contributes to the overall gait dysfunction observed in children with bilateral CP.
Abstract:
Children with bilateral cerebral palsy (CP) commonly have limited selective motor control (SMC). This affects their ability to complete functional tasks. The impact of impaired SMC on walking has yet to be fully understood. Measures of SMC have been shown to correlate with specific characteristics of gait, however the impact of SMC on overall gait pattern has not been reported. This study explored SMC data collected as part of routine gait analysis in children with bilateral CP. As part of their clinical assessment, SMC was measured with the Selective Control Assessment of the Lower Extremities (SCALE) in 194 patients with bilateral cerebral palsy attending for clinical gait analysis at a single centre. Their summed SCALE score was compared with overall gait impairment, as measured by Gait Profile Score (GPS). Score on SCALE showed a significant negative correlation with GPS (rs=-0.603, p<0.001). Cerebral injuries in CP result in damage to the motor tracts responsible for SMC. Our results indicate that this damage is also associated with changes in the development of walking pattern in children with CP.
