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Relationship between Movement Quality, Functional Ambulation Status, and Spatiotemporal Gait Parameters in Children
Megan B Flores1, Kathleen J Manella1, Elizabeth M Ardolino1
1Doctor of Physical Therapy Program, University of St. Augustine for Health Sciences, Austin, Texas, USA.
Insights
Children with myelomeningocele (MMC) scoring higher on the Pediatric Neuromuscular Recovery Scale (Peds NRS) showed better gait. Improved movement quality and trunk control correlate with functional ambulation and optimal spatiotemporal gait parameters in pediatric MMC patients.
Area of Science:
- Pediatric Neurology
- Rehabilitation Medicine
- Biomechanical Analysis
Background:
- Myelomeningocele (MMC) is a complex congenital condition affecting neurological and motor development.
- Assessing functional recovery and gait in children with MMC requires reliable and valid outcome measures.
- Understanding the relationship between neuromuscular function and gait parameters is crucial for targeted interventions.
Purpose of the Study:
- To investigate the correlations between the Pediatric Neuromuscular Recovery Scale (Peds NRS) and the modified Hoffer Scale in children with MMC.
- To examine the associations between Peds NRS/modified Hoffer Scale scores and spatiotemporal gait parameters in this population.
- To determine if improved movement quality and trunk control predict better gait function in children with MMC.
Main Methods:
- Twenty-one children diagnosed with MMC, with a mean age of 5.3 years, were evaluated.
- Three clinicians administered the Peds NRS and modified Hoffer Scale to all participants.
- Spatiotemporal gait parameters were measured in a subset of eight children.
Main Results:
- The Peds NRS summary score showed a significant negative correlation with the modified Hoffer Scale (r = -0.64, p = 0.002).
- Specific Peds NRS items, particularly sit-to-stand, demonstrated strong relationships with the modified Hoffer Scale (r = -0.85, p < 0.001).
- Peds NRS items and modified Hoffer Scale scores correlated well with gait parameters like cadence, swing/stance time, and velocity (p ≤ 0.047).
Conclusions:
- Higher scores on the Peds NRS, indicating better movement quality and trunk control, are associated with improved functional ambulation in children with MMC.
- The Peds NRS appears to be a valuable tool for assessing functional recovery and predicting gait outcomes in pediatric populations with neuromuscular conditions.
- These findings support the use of the Peds NRS in clinical practice to guide rehabilitation strategies for children with MMC.
Aims:
We investigated relationships among the Pediatric Neuromuscular Recovery Scale (Peds NRS), modified Hoffer Scale, and spatiotemporal gait parameters in children with myelomeningocele (MMC).
Methods:
21 children with MMC, age 5.3 years (SD = 2.6), were assessed by three clinicians using the Peds NRS and modified Hoffer Scale. In eight children, gait parameters were also measured.
Results:
The Peds NRS summary score demonstrated good correlation with modified Hoffer Scale score (r = -0.64, p = 0.002) that accounted for 41% of variation in summary score. Six Peds NRS seated/standing items exhibited good relationships with modified Hoffer Scale (r = -0.51 to -0.70, p ≤ 0.023), and the sit-to-stand item demonstrated an excellent relationship (r = -0.85, p < 0.001). Sit-to-stand and three standing/walking items exhibited excellent associations with cadence (Rs = 0.81 to 0.88, p ≤ 0.014), and swing and stance time (both Rs = -0.83 to -0.90, p ≤ 0.01). Two Peds NRS standing items and modified Hoffer Scale score demonstrated good correlations with velocity (Rs = 0.71, p = 0.047; Rs = -0.73, p = 0.04, respectively).
Conclusions:
Our findings suggest that children with MMC who exhibit greater movement quality and trunk control are likely to be functional ambulators with more optimal spatiotemporal gait parameters.
