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Head and Trunk Movements During Turning Gait in Children with Cerebral Palsy

Asa Bartonek1, Cecilia Lidbeck2, Kerstin Hellgren3

  • 1a Women's and Children's Health, Motoriklab , Karolinska Institutet , Stockholm , Sweden .

Journal of Motor Behavior
|October 17, 2018
PubMed

Insights

Children with cerebral palsy (CP) showed altered trunk and head movements during gait analysis. These changes, particularly increased trunk flexion and reduced rotation, correlate with Gross Motor Function Classification System (GMFCS) levels, indicating potential sensory and spatial control deficits.

Area of Science:

  • Neurology
  • Biomechanics
  • Pediatrics

Background:

  • Cerebral palsy (CP) is a common neurodevelopmental disorder affecting motor function.
  • Understanding gait deviations in children with CP is crucial for targeted interventions.
  • Gross Motor Function Classification System (GMFCS) levels provide a framework for categorizing CP severity.

Purpose of the Study:

  • To investigate differences in trunk and head kinematics during turning in children with CP compared to typically developing (TD) children.
  • To correlate kinematic findings with GMFCS levels in children with CP.
  • To explore the potential sensory and motor control strategies employed by children with CP during gait.

Main Methods:

  • 3D gait analysis was performed on 30 children with CP (classified by GMFCS levels I, II, and III) and 22 TD children.
  • Kinematic data, including trunk rotation and head/trunk flexion, were collected during turning tasks.
  • Trial time was measured and analyzed in relation to GMFCS level.

Main Results:

  • Children with CP showed significantly larger trunk rotation at the turn compared to TD and GMFCS I groups (CP2).
  • Head flexion was greater in GMFCS III (CP3) children than TD.
  • Maximum head and trunk flexion, as well as trunk flexion in CP2, were elevated compared to TD; trial time increased with GMFCS level.

Conclusions:

  • Reduced trunk rotation in CP2 suggests spatial insecurity, potentially compensated by walkers in CP3.
  • Increased head and trunk flexion in CP3 and trunk flexion in CP2 may indicate reliance on visual control due to proprioceptive and sensory deficits.
  • Gait kinematics in children with CP are significantly altered and directly related to functional motor impairment levels (GMFCS).

Keywords:
gaitperceptionproprioceptionsensationspatial orientation

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