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Effect of altering handle position of a rolling walker on gait in children with cerebral palsy
P K Levangie1, M F Guihan, P Meyer
1Department of Physical Therapy, Sargent College of Allied Health Professions, Boston University, MA 02215.
Insights
Altering rolling walker handle position did not significantly change gait patterns in children with spastic cerebral palsy. This suggests vertical handles should not be prescribed assuming immediate gait improvements.
Area of Science:
- Pediatrics
- Neurology
- Biomechanical Engineering
Background:
- Spastic cerebral palsy (CP) affects motor control, impacting gait.
- Rolling walkers are common assistive devices for children with CP.
- Walker design, including handle position, may influence gait mechanics.
Purpose of the Study:
- To investigate the effect of rolling walker handle position (horizontal vs. vertical) on the gait patterns of children with spastic CP.
- To provide evidence-based recommendations for prescribing rolling walkers for pediatric CP.
Main Methods:
- Sixteen children (2-10 years) with spastic CP participated.
- Gait trials were conducted with horizontal and vertical walker handle positions.
- Gait parameters (step width, length, stride length, cadence, velocity) were measured using the footprint-on-paper method.
Main Results:
- No statistically significant differences in gait characteristics were observed between horizontal and vertical handle positions.
- Significant differences were noted between the first trial and subsequent trials, indicating an adaptation period.
Conclusions:
- Immediate changes in gait characteristics are not expected when altering rolling walker handle position in children with CP.
- Prescribing vertical-handled walkers should not be based on the assumption of immediate gait pattern alteration.
- Further research may explore long-term effects or other benefits of different handle positions.
Abstract:
The purpose of this study was to determine whether altering the handle position on a rolling walker would affect the gait pattern of children with spastic cerebral palsy (CP). Sixteen children with CP (2-10 years old) performed six gait trials, three with the handle on the rolling walker positioned horizontally and three with the handle positioned vertically. Using the footprint-on-paper method, gait characteristics of right and left step width, step length, and stride length; cadence; and velocity were determined. A two-way analysis of variance for two repeated measures indicated no significant differences in the measured gait characteristics between handle positions. Significant differences between the first trial and subsequent trials for both horizontal and vertical handle positions were found using Duncan's multiple comparison test. This study suggests that in this sample of children, altering the handle position did not lead to any immediate statistically significant changes in the gait characteristics measured. Results suggest that walkers with vertical handles should not be prescribed under the assumption that the gait characteristics of the child using the walker will be changed. This study does not rule out other changes that might occur with the use of vertical-handled walkers.