Gait parameters in children with bilateral spastic cerebral palsy: a systematic review of randomized controlled...

Area of Science:

• Biomedical Engineering
• Clinical Biomechanics
• Pediatric Neurology

Background:

• Bilateral spastic cerebral palsy (CP) significantly impacts children's gait.
• Instrumented gait analysis (IGA) is crucial for objective assessment of gait disorders.
• Identifying responsive gait parameters is essential for evaluating treatment efficacy in pediatric CP.

Purpose of the Study:

• To systematically identify gait parameters used in assessing gait disorders in children with bilateral spastic CP.
• To evaluate the responsiveness of these gait parameters to various clinical interventions.
• To establish a comprehensive list of effective outcome measures for pediatric CP gait rehabilitation.

Main Methods:

• Systematic literature search of PubMed, Web of Science, and Scopus (2000-2016).
• Inclusion of randomized controlled trials focusing on children with bilateral spastic CP assessed via IGA.
• Data extraction on participant/study characteristics, risk of bias, and outcome measures.

Main Results:

• Twenty-one studies met inclusion criteria, identifying 89 gait parameters.
• Fifty-six gait parameters demonstrated responsiveness to treatments.
• Spatiotemporal and kinematic parameters, particularly sagittal plane joint angles, were most frequently identified and responsive.

Conclusions:

• Instrumented gait analysis provides responsive outcome measures for children with bilateral spastic CP.
• Spatiotemporal and kinematic parameters are widely utilized and effective for gait assessment in this population.
• Further research is needed to correlate specific gait parameters with distinct clinical problems in pediatric CP.