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Improving Trunk Postural Control Facilitates Walking in Children With Cerebral Palsy: A Pilot Study
Shijun Yan1, Seoung Hoon Park, Renee Keefer
1From the Legs and Walking Lab, Shirley Ryan AbilityLab, Chicago, Illinois (SY, SHP, RK, WD, A-MR, WZR, MW); Department of Physical Medicine and Rehabilitation, Northwestern University, Chicago, Illinois (SY, SHP, A-MR, WZR, MW); and Department of Biomedical Engineering, University of Illinois at Chicago, Chicago, Illinois (MW).
Insights
Bilateral trunk support during walking improved gait in children with cerebral palsy. Support enhanced pelvis movement and leg kinematics, potentially improving walking ability.
Area of Science:
- Pediatrics
- Neurology
- Biomechanics
Background:
- Cerebral palsy (CP) often impairs motor function, affecting gait.
- Trunk control is crucial for effective walking in children with CP.
Purpose of the Study:
- To investigate the effects of bilateral trunk support on gait kinematics and muscle activity in children with CP.
- To determine if different levels of trunk support influence walking patterns.
Main Methods:
- Fourteen children with spastic CP (GMFCS I-III) walked on a treadmill.
- Trunk and leg kinematics and muscle activity were recorded under four conditions: no support, upper trunk support, lower trunk support, and combined support.
Main Results:
- Bilateral trunk support significantly impacted pelvis and trunk displacement.
- Children exhibited increased step length and step height in their weaker leg with combined trunk support.
- Soleus muscle activity changes correlated with step length variations.
Conclusions:
- Bilateral upper or combined trunk support may enhance gait performance in children with CP.
- Improved pelvic kinematics and trunk postural control appear to facilitate walking.
Objective:
The aim of this study is to determine the effects of bilateral trunk support during walking on trunk and leg kinematics and neuromuscular responses in children with cerebral palsy.
Design:
Fourteen children with spastic cerebral palsy (Gross Motor Function Classification System level I to III) participated in this study. Children walked on a treadmill under four different conditions, that is, without support (Baseline), with bilateral support applied to the upper trunk (upper trunk support), the lower trunk (lower trunk support), and combined upper and lower trunk (combined trunk support). The trunk and leg kinematics and muscle activity were recorded.
Results:
Providing bilateral support to the trunk had a significant impact on the displacement of the pelvis and trunk ( P < 0.003) during walking. Children's weaker leg showed greater step length ( P = 0.032) and step height ( P = 0.012) in combined trunk support compared with baseline and greater step length in upper trunk support ( P = 0.02) and combined trunk support ( P = 0.022) compared with lower trunk support. Changes in soleus electromyographic activity during stance phase of gait mirrored the changes in step length across all conditions.
Conclusions:
Providing bilateral upper or combined upper and lower trunk support during walking may induce improvements in gait performance, which may be due to improved pelvis kinematics. Improving trunk postural control may facilitate walking in children with cerebral palsy.
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