Are clinic-based walking measures associated with community walking activity in children with cerebral palsy?

Area of Science:

• Pediatrics
• Rehabilitation Medicine
• Movement Science

Background:

• Ambulatory children with cerebral palsy (CP) often face challenges in community mobility.
• Assessing real-world walking activity is crucial for understanding functional limitations and intervention effectiveness in this population.

Purpose of the Study:

• To investigate the relationship between common clinic-based walking capacity assessments and objectively measured community-based walking activity in children with CP.
• To determine if standardized clinical tests can predict daily walking performance.

Main Methods:

• A secondary analysis utilized data from a cross-sectional cohort of 128 ambulatory children (ages 2-9 years, GMFCS I-III).
• Walking capacity was assessed using the 1-minute walk test (1MWT), 6-minute walk test (6MWT), GMFM-E, and the Activity Scale for Kids (ASKp-30).
• Community walking activity was objectively measured using the StepWatch (SW) device.

Main Results:

• The 6MWT showed moderate correlations with community walking level, intensity, and peak activity (r=0.55-0.58).
• The GMFM-E demonstrated moderate to high correlations with most SW outputs (r=0.55-0.69), indicating strong associations with walking level and intensity.
• Regression models confirmed that GMFM-E and 6MWT were significant predictors of daily walking level and intensity.

Conclusions:

• The 6-minute walk test (6MWT) and Gross Motor Function Measure-E (GMFM-E) are strongly associated with the level, amount, and intensity of daily community walking in ambulatory children with cerebral palsy.
• These clinical measures offer a feasible method for estimating community walking activity, aiding in clinical practice and research for children with CP.
• Further research should explore environmental and personal factors influencing community walking performance in this population.