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Determining the relationship between the impairment of selective voluntary motor control and gait deviations in
Cansu Sardoğan1, Rasmi Muammer2, Nazif Ekin Akalan3
1Yeditepe University, Institute of Health Sciences, Department of Physiotherapy and Rehabilitation, Istanbul, Turkey.
Insights
Video-based observational gait analysis (VBOGA) effectively assesses selective voluntary motor control (SVMC) in children with cerebral palsy (CP). This simple method correlates well with complex 3D gait analysis, aiding in tailored physical therapy.
Area of Science:
- Pediatrics
- Neurology
- Rehabilitation Medicine
Background:
- Cerebral palsy (CP) impairs selective voluntary motor control (SVMC), impacting gait.
- Complex 3D gait analysis (3DGA) has linked SVMC impairment to gait characteristics in children with CP.
- The utility of simple video-based observational gait analysis (VBOGA) for this assessment remains underexplored.
Purpose of the Study:
- To investigate the relationship between VBOGA and SVMC in the lower extremities of children with CP.
- To determine if VBOGA can serve as a viable alternative to 3DGA for assessing SVMC in pediatric CP.
Main Methods:
- Forty-two children with CP (GMFCS levels I-III, age 10.9 ± 5.7 years) were assessed.
- Gait characteristics were evaluated using the Edinburgh Visual Gait Score (EVGS).
- Selective voluntary motor control was measured with the Selective Control Assessment of the Lower Extremity (SCALE), using Spearman's rho correlation.
Main Results:
- Strong correlations were found between GMFCS levels, foot clearance, and ankle dorsiflexion during swing phase with total SCALE scores.
- Moderate correlations existed between total SCALE scores and total EVGS, knee extension, trunk sagittal position, and lateral trunk shift.
- The correlations between SCALE and VBOGA measures were comparable to those reported for 3DGA.
Conclusions:
- Impaired lower extremity SVMC in children with CP is associated with specific gait deviations, particularly in foot, ankle, and trunk movements.
- VBOGA demonstrates a strong potential for evaluating SVMC gait impairments in CP, mirroring findings from complex 3DGA.
- These results support the use of VBOGA for tailoring physical therapy interventions to improve motor control and walking quality in children with CP.
Background:
The impairment of selective voluntary motor control (SVMC) in children with cerebral palsy (CP) has been shown to correlate with their gait characteristics using complex 3D gait analysis systems (3DGA); however, this relationship has not been investigated using simple video-based observational gait analysis (VBOGA). The aim of this study was to determine the relationship between VBOGA and SVMC of the lower extremities in children with CP.
Methods:
Forty-two CP children 10.9 ± 5.7 years old with Gross Motor Function Classification System (GMFCS) levels I-III participated in the study. Their gait characteristics were assessed using the Edinburgh Visual Gait Score (EVGS), and selective voluntary motor control was tested using the Selective Control Assessment of the Lower Extremity (SCALE). Spearman's rho correlation test with Cohen's classification were used in the statistical analyses.
Results:
The GMFCS levels (r = 0.604, p < 0.001), foot clearance (r = -0.584. p < 0.001), and maximum ankle dorsiflexion (r =-0.567, p < 0.001) during the swing phase had strong correlations with total SCALE scores. There was also a moderate correlation between total SCALE scores and total EVGS (r =-0.494, p < 0.001), knee extension in the terminal swing phase (r = -0.353, p < 0.001), peak sagittal trunk position (r = -0.316, p < 0.005), and maximum lateral shift (r = -0.37, p < 0.001).
Conclusion:
Impaired lower extremity SVMC was noticeably related to the foot and ankle movements in the swing phase and initial stance during walking as well as the total EVGS scores and sagittal and frontal trunk movements. The SCALE correlations with VBOGA were similar those observed in the complex 3DGA in the literature; therefore, we suggest that SVMC impairment of gait could be evaluated using simple VBOGA. These findings may help to tailor physical therapy programs for CP children to increase their motor control and walking quality.
