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The association between the maximum step length test and the walking efficiency in children with cerebral palsy
Minoru Kimoto1,2, Kyoji Okada1, Hitoshi Sakamoto2
1Department of Physical Therapy, Akita University Graduate School of Health Sciences, Japan.
Insights
Maximum step length on the dominant side is the best indicator of walking efficiency in children with cerebral palsy (CP). This finding can help improve mobility and reduce fatigue in affected children.
Area of Science:
- Pediatrics
- Rehabilitation Medicine
- Biomechanical Engineering
Background:
- Children with cerebral palsy (CP) often experience reduced walking efficiency, leading to increased fatigue.
- Improving walking efficiency is crucial for enhancing mobility and independence in children with CP.
- Current evaluations of walking efficiency in CP lack a definitive, easily measurable parameter.
Purpose of the Study:
- To identify the most effective parameter for evaluating walking efficiency in children with CP.
- To compare conventional gross motor performance and spatio-temporal parameters against a validated measure of walking efficiency.
- To determine if maximum step length (MSL) is a significant predictor of walking efficiency.
Main Methods:
- Thirty-one children with CP (mean age 12.3 years) participated in the study.
- Evaluated gross motor parameters (e.g., MSL, single leg standing time) and spatio-temporal gait parameters (speed, step length, cadence).
- Calculated the Total Heart Beat Index (THBI) as a measure of walking efficiency over a 10-minute walk.
Main Results:
- The maximum step length (MSL) of the dominant side demonstrated the strongest correlation with the Total Heart Beat Index (THBI), explaining 75.9% of the variance (R²=0.759).
- Other gross motor and spatio-temporal parameters showed weaker associations with walking efficiency compared to dominant side MSL.
- Stepwise analysis confirmed MSL as the primary explanatory variable for THBI.
Conclusions:
- Maximum step length of the dominant side is the most significant and reliable parameter for assessing walking efficiency in children with cerebral palsy.
- This finding offers a practical metric for clinicians to evaluate and monitor improvements in walking efficiency.
- Utilizing dominant side MSL can aid in developing targeted interventions to enhance gait and reduce energy expenditure in children with CP.
Abstract:
[Purpose] To improve walking efficiency could be useful for reducing fatigue and extending possible period of walking in children with cerebral palsy (CP). For this purpose, current study compared conventional parameters of gross motor performance, step length, and cadence in the evaluation of walking efficiency in children with CP. [Subjects and Methods] Thirty-one children with CP (21 boys, 10 girls; mean age, 12.3 ± 2.7 years) participated. Parameters of gross motor performance, including the maximum step length (MSL), maximum side step length, step number, lateral step up number, and single leg standing time, were measured in both dominant and non-dominant sides. Spatio-temporal parameters of walking, including speed, step length, and cadence, were calculated. Total heart beat index (THBI), a parameter of walking efficiency, was also calculated from heartbeats and walking distance in 10 minutes of walking. To analyze the relationships between these parameters and the THBI, the coefficients of determination were calculated using stepwise analysis. [Results] The MSL of the dominant side best accounted for the THBI (R2=0.759). [Conclusion] The MSL of the dominant side was the best explanatory parameter for walking efficiency in children with CP.
