Factors associated with gait efficiency in children with cerebral palsy: association between gait abnormality and balance ability
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Updated: Jul 6, 2025
Clinical-oriented Three-dimensional Gait Analysis Method for Evaluating Gait Disorder
Published on: March 4, 2018
Sosei Ishimoto1,2, Masafumi Itokazu1
1Graduate School of Health and Welfare Sciences, International University of Health and Welfare: 2600-1 Kitakanemaru, Otawara-shi, Tochigi 324-8501, Japan.
Insights
Children with cerebral palsy have inefficient gait. Gait abnormalities and balance issues significantly impact their walking efficiency, highlighting the need for targeted therapeutic strategies.
Area of Science:
- Pediatrics
- Neurology
- Biomechanics
Background:
- Children with cerebral palsy (CP) exhibit increased gait energy expenditure compared to typically developing children.
- The relationship between specific gait abnormalities, balance, and overall gait efficiency in pediatric CP populations is not fully understood.
Purpose of the Study:
- To investigate the association between gait abnormalities, balance, and maximum step length in children with CP.
- To identify key contributors to gait efficiency in this population.
Main Methods:
- The study included 33 ambulatory children with CP.
- Gait efficiency was measured using the Total Heart Beat Index during a 6-minute walk test.
- Gait abnormalities were assessed using the Edinburgh Visual Gait Score, and balance was evaluated with the Berg Balance Scale.
Main Results:
- The Edinburgh Visual Gait Score demonstrated correlations with heel lift during stance and knee position during terminal swing, both linked to the Total Heart Beat Index.
- The Berg Balance Scale showed correlations with 360° turning and standing with feet together.
- Specific gait deviations and balance deficits were identified as significant factors influencing walking efficiency.
Conclusions:
- Gait abnormalities, particularly those related to stance and swing phases, are associated with reduced gait efficiency in children with CP.
- Impaired balance, as indicated by performance on the Berg Balance Scale, also contributes to inefficient gait.
- Treatment strategies should address both gait deviations and balance deficits to improve walking efficiency in children with cerebral palsy.
Abstract:
[Purpose] Children with cerebral palsy require more gait energy than healthy children. The association between gait abnormalities and gait efficiency remains unclear. We investigated the association between gait abnormalities, balance, and maximum step length to determine contributors to gait efficiency in children with cerebral palsy. [Participants and Methods] The study included 33 patients with cerebral palsy, who could walk without the use of walking aids. All participants were instructed to walk for 6 min, and the Total Heart Beat Index was calculated as a measure of walking efficiency. The Edinburgh Visual Gait Score was used to assess gait abnormalities. Additionally, the maximum step length was recorded, and all participants performed the Berg Balance Scale. Correlation analysis and stepwise multiple regression analysis were used to confirm the association between the aforementioned parameters and the Total Heart Beat Index. [Results] The Edinburgh Visual Gait Score was correlated with the heel lift during the stance, knee position during the terminal swing of gait as factors associated with the Total Heartbeat Index. The Berg Balance Scale was correlated with turning 360°, standing with feet together. [Conclusion] Our findings emphasize the need for treatment strategies focused on gait abnormalities and balance.
