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Fatigue-related gait adaptations in children with cerebral palsy

Laura M Oudenhoven1,2, Marjolein M Van Der Krogt1,2, Sanne Ettema3,4

  • 1Rehabilitation Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.

Developmental Medicine and Child Neurology
|May 27, 2023
PubMed

Insights

Prolonged walking worsens gait in children with cerebral palsy (CP), affecting knee and ankle movements. Fatigue impacts gait kinematics but not energy cost, suggesting personalized interventions for CP patients.

Area of Science:

  • Biomechanical analysis of human movement.
  • Pediatric rehabilitation and motor control.

Background:

  • Children with cerebral palsy (CP) often exhibit altered gait patterns.
  • Understanding the impact of fatigue on gait is crucial for rehabilitation.

Purpose of the Study:

  • To investigate the effects of prolonged walking-induced fatigue on gait kinematics, kinetics, and energy cost of walking (ECoW) in children with CP.

Main Methods:

  • A prospective observational study involving children with CP and typically developing children.
  • A prolonged, intensity-based walking protocol on an instrumented treadmill with gas analysis.
  • Gait parameters, kinetics, and ECoW were assessed before and after a 6-minute walk and moderate-intensity walking exercise.

Main Results:

  • Gait Profile Scores worsened in both groups with prolonged walking.
  • Children with CP showed increased knee flexion and ankle dorsiflexion during specific gait phases.
  • No significant changes in gait kinetics or energy cost of walking were observed in either group.

Conclusions:

  • Kinematic deviations in children with CP progress with prolonged walking.
  • Significant individual variability in gait adaptations to fatigue was observed.
  • An individualized approach is recommended for assessing fatigue effects on gait in clinical practice for children with CP.
Abstract

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