Squat test performance and execution in children with and without cerebral palsy

Area of Science:

• Pediatrics
• Rehabilitation Medicine
• Biomechanics

Background:

• Assessing lower extremity strength is crucial for managing mobility issues in children with cerebral palsy (CP).
• A functional and clinically practical assessment tool is currently lacking for this population.
• This study evaluates the squat test's suitability for assessing strength in children with CP.

Purpose of the Study:

• To determine the squat test's feasibility and performance in children with CP compared to typically developing (TD) children.
• To investigate muscle fatigue and joint kinematics during the squat test in both groups.

Main Methods:

• Twenty children with bilateral CP (GMFCS I-III) and sixteen TD children performed two-legged squats to fatigue (max 20).
• Electromyography (EMG) assessed muscle fatigue, while joint range-of-motion and net torque were calculated.
• Differences between groups and between the second and last squat were analyzed.

Main Results:

• Children with CP performed fewer squats (median 13) than TD children (median 20).
• Both groups exhibited muscle fatigue; children with CP showed reduced ankle and knee range-of-motion.
• Knee range-of-motion changes differed, increasing in TD children and decreasing in children with CP during the test.

Conclusions:

• The squat test is a feasible and clinically relevant method for assessing lower extremity strength in children with CP.
• Reduced performance and specific kinematic differences highlight the test's sensitivity to CP-related impairments.
• Further clinimetric evaluation is recommended before widespread clinical adoption.