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Updated: Jul 31, 2025
Asymmetric Walkway: A Novel Behavioral Assay for Studying Asymmetric Locomotion
Published on: January 15, 2016
Comparison of the forward and sideways locomotor patterns in children with Cerebral Palsy
Germana Cappellini1,2, Francesca Sylos-Labini1,2, Priscilla Avaltroni1
1Laboratory of Neuromotor Physiology, Istituto di Ricovero e Cura a Carattere Scientifico Fondazione Santa Lucia, 306 Via Ardeatina, 00179, Rome, Italy.
Insights
Children with cerebral palsy (CP) struggle with sideways walking, showing developmental deficits in gait control and coordination. Sideways locomotion challenges and may improve motor adaptability in children with CP.
Area of Science:
- Neuroscience
- Developmental Pediatrics
- Biomechanical Engineering
Background:
- Sideways walking (SW) is crucial for adaptable locomotion but understudied in children with cerebral palsy (CP).
- Assessing SW in children with CP offers insights into gait flexibility and potential rehabilitation strategies.
Purpose of the Study:
- To compare forward (FW) and sideways (SW) locomotion in children with CP versus typically developing (TD) children.
- To analyze gait kinematics, joint moments, and muscle activity during FW and SW tasks.
- To investigate motor module adjustments for different locomotion styles in children with CP.
Main Methods:
- Cross-sectional study of 27 children with CP (2-10 years) and 18 TD children.
- Analysis of gait kinematics, joint moments, and EMG activity from 12 muscle pairs.
- Factorization of EMG signals to evaluate muscle modules during FW and SW.
Main Results:
- Children with CP exhibited significant differences in SW task performance compared to TD children.
- Only two-thirds of children with CP successfully stepped sideways, often attempting FW instead.
- Children with CP showed less distinct motor modules for FW and SW compared to TD children, indicating developmental deficits in gait control and bilateral coordination.
Conclusions:
- Children with CP display developmental deficits in gait control, bilateral coordination, and motor module adaptation.
- Sideways locomotion presents a novel challenge that may serve as a valuable rehabilitation tool for improving motor performance in children with CP.
Abstract:
Switching locomotion direction is a common task in daily life, and it has been studied extensively in healthy people. Little is known, however, about the locomotor adjustments involved in changing locomotion direction from forward (FW) to sideways (SW) in children with cerebral palsy (CP). The importance of testing the ability of children with CP in this task lies in the assessment of flexible, adaptable adjustments of locomotion as a function of the environmental context. On the one hand, the ability of a child to cope with novel task requirements may provide prognostic cues as to the chances of modifying the gait adaptively. On the other hand, challenging the child with the novel task may represent a useful rehabilitation tool to improve the locomotor performance. SW is an asymmetrical locomotor task and requires a differential control of right and left limb muscles. Here, we report the results of a cross-sectional study comparing FW and SW in 27 children with CP (17 diplegic, 10 hemiplegic, 2-10 years) and 18 age-matched typically developing (TD) children. We analyzed gait kinematics, joint moments, EMG activity of 12 pairs of bilateral muscles, and muscle modules evaluated by factorization of EMG signals. Task performance in several children with CP differed drastically from that of TD children. Only 2/3 of children with CP met the primary outcome, i.e. they succeeded to step sideways, and they often demonstrated attempts to step forward. They tended to rotate their trunk FW, cross one leg over the other, flex the knee and hip. Moreover, in contrast to TD children, children with CP often exhibited similar motor modules for FW and SW. Overall, the results reflect developmental deficits in the control of gait, bilateral coordination and adjustment of basic motor modules in children with CP. We suggest that the sideways (along with the backward) style of locomotion represents a novel rehabilitation protocol that challenges the child to cope with novel contextual requirements.
